Nursing Elites

1. A nurse is caring for a client who has been experiencing repeated tonic-clonic seizures over the course of 30 minutes. After maintaining the client's airway and turning the client on their side, which of the following medications should the nurse administer?

• A. Diazepam IV
• B. Lorazepam PO
• C. Diltiazem IV
• D. Clonazepam PO

Correct answer: A

Rationale: In the scenario described, where the client has been experiencing repeated tonic-clonic seizures over an extended period, the priority is to administer a medication that can rapidly terminate the seizures. Diazepam is the medication of choice for status epilepticus due to its rapid onset of action within 10 minutes when administered intravenously. Lorazepam is also an option, but it is typically administered intravenously as well. Diltiazem is a calcium channel blocker used for conditions like hypertension and angina, not for seizures. Clonazepam, although used for seizures, is not the ideal choice in this acute situation due to its slower onset of action compared to benzodiazepines like diazepam and lorazepam.

2. What are the expected symptoms in a patient with a thrombotic stroke?

• A. Gradual loss of function on one side of the body
• B. Sudden loss of consciousness
• C. Severe headache and confusion
• D. Loss of sensation in the affected limb

Correct answer: A

Rationale: A thrombotic stroke typically presents with a gradual loss of function on one side of the body. This gradual onset distinguishes it from a hemorrhagic stroke, which often manifests with sudden and severe symptoms like loss of consciousness (choice B), severe headache and confusion (choice C), or loss of sensation in the affected limb (choice D). Therefore, choices B, C, and D are not typically associated with thrombotic strokes.

3. What is the initial nursing action for a patient with chest pain and acute coronary syndrome?

• A. Administer sublingual nitroglycerin
• B. Check the patient's urine output
• C. Check cardiac enzymes
• D. Obtain IV access

Correct answer: A

Rationale: Administering sublingual nitroglycerin is the priority initial action for a patient with chest pain and acute coronary syndrome. Nitroglycerin helps vasodilate coronary arteries, improving blood flow to the heart muscle and reducing chest pain. Checking the patient's urine output (choice B) and cardiac enzymes (choice C) are important assessments but are not the first priority when managing acute chest pain. Obtaining IV access (choice D) is essential for administering medications and fluids, but administering sublingual nitroglycerin takes precedence in the initial management of chest pain in acute coronary syndrome.

4. What dietary changes should a patient with GERD make to manage their symptoms?

• A. Avoid mint and spicy foods
• B. Eat large, frequent meals
• C. Consume liquids with meals
• D. Eat small, frequent meals

Correct answer: A

Rationale: The correct answer is A: Avoid mint and spicy foods. Patients with GERD should avoid foods like mint and spicy dishes as they can trigger symptoms by increasing gastric acid secretion. Choices B, C, and D are incorrect. Eating large, frequent meals can exacerbate GERD symptoms by putting more pressure on the lower esophageal sphincter, consuming liquids with meals can lead to increased reflux, and eating small, frequent meals is the recommended approach to reduce symptoms and manage GERD.

5. What teaching should be provided after cataract surgery?

• A. Avoid NSAIDs
• B. Wear dark glasses outdoors
• C. Creamy white drainage is normal
• D. Avoid bright lights

Correct answer: A

Rationale: The correct teaching that should be provided after cataract surgery is to avoid NSAIDs. NSAIDs should be avoided to prevent bleeding, especially in the eye area. While wearing dark glasses outdoors is important to protect the eyes, it is not the most critical teaching after cataract surgery. Creamy white drainage being normal is not relevant to post-cataract surgery teaching. Avoiding bright lights is generally recommended for patients with certain eye conditions but is not a specific teaching point after cataract surgery.

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