Nursing Elites

1. A client with rheumatoid arthritis is experiencing morning stiffness. Which of the following actions should the nurse take?

• A. Encourage the client to avoid physical activity in the morning.
• B. Encourage the client to take NSAIDs before bedtime.
• C. Apply cold packs to the affected joints in the morning.
• D. Perform passive range-of-motion exercises before getting out of bed.

Correct answer: C

Rationale: The correct action the nurse should take is to apply cold packs to the affected joints in the morning. Rheumatoid arthritis is characterized by inflammation, and applying cold packs can help reduce inflammation and stiffness in the joints. Encouraging the client to avoid physical activity in the morning (Choice A) may worsen stiffness, as movement is beneficial for joint mobility. While NSAIDs (Choice B) can help with pain and inflammation, applying cold packs directly to the affected joints is more targeted and effective. Performing passive range-of-motion exercises (Choice D) can be helpful, but applying cold packs is the priority for reducing inflammation and stiffness.

2. What is the priority intervention for a patient presenting with chest pain?

• A. Administer aspirin
• B. Administer nitroglycerin
• C. Reposition the patient
• D. Prepare for surgery

Correct answer: A

Rationale: The correct answer is to administer aspirin. Administering aspirin is a priority intervention for a patient presenting with chest pain because it helps reduce the risk of further clot formation and improves oxygenation. Aspirin is commonly used in the initial management of suspected cardiac chest pain. Administering nitroglycerin can follow aspirin administration to help with vasodilation. Repositioning the patient or preparing for surgery are not the primary interventions for chest pain presentation.

3. A client with type 2 diabetes mellitus is scheduled for an arteriogram. Which of the following medications should the nurse instruct the client to discontinue 48 hours prior to the procedure?

• A. Atorvastatin
• B. Digoxin
• C. Nifedipine
• D. Metformin

Correct answer: D

Rationale: The correct answer is D, Metformin. Metformin should be discontinued 48 hours before an arteriogram due to the risk of lactic acidosis. Atorvastatin (Choice A) is a statin used to lower cholesterol levels and is not typically contraindicated before an arteriogram. Digoxin (Choice B) is a medication used for heart conditions and does not need to be discontinued before an arteriogram. Nifedipine (Choice C) is a calcium channel blocker used to treat high blood pressure and angina, and it is not necessary to discontinue before the procedure.

4. A healthcare professional is preparing to administer an intermittent enteral feeding to a client who has a nasogastric tube. Which of the following actions should the healthcare professional take first?

• A. Check the residual volume before administering the feeding
• B. Elevate the head of the bed to 30 degrees
• C. Flush the tube with 10 mL of sterile water
• D. Verify the client's tube placement

Correct answer: D

Rationale: Verifying the client's tube placement is the priority before administering any enteral feeding. This step ensures that the tube is correctly positioned in the stomach or intestines, minimizing the risk of complications such as aspiration. Checking the residual volume, elevating the head of the bed, and flushing the tube are important steps but should occur after confirming the tube placement to ensure the feeding is delivered safely and effectively.

5. A nurse is providing teaching to a client who has mild persistent asthma and has been prescribed montelukast. Which of the following statements should the nurse include in the teaching?

• A. This medication can be used to help you during an acute asthma attack.
• B. This medication helps decrease swelling and mucus production.
• C. This medication should be taken before exercise.
• D. This medication should be taken daily in the evening.

Correct answer: D

Rationale: The correct answer is D. Montelukast should be taken daily in the evening for long-term control of asthma, rather than for immediate relief. Choice A is incorrect because montelukast is not used for acute asthma attacks. Choice B is incorrect as montelukast works by blocking leukotrienes, not by decreasing swelling and mucus production. Choice C is incorrect as montelukast is not specifically taken before exercise.

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