Nursing Elites

1. A client, 12 hours postpartum, reports not having a bowel movement for 4 days. Which medication should the nurse administer?

• A. Bisacodyl 10 mg rectal suppository.
• B. Magnesium hydroxide 30 ml PO.
• C. Famotidine 20 mg PO.
• D. Loperamide 4 mg PO.

Correct answer: A

Rationale: In this scenario, the nurse should administer Bisacodyl 10 mg rectal suppository. The client's report of not having a bowel movement for 4 days indicates constipation, and Bisacodyl is a stimulant laxative that helps initiate bowel movements. Magnesium hydroxide is an antacid and osmotic laxative used for indigestion, not for constipation. Famotidine is an H2 receptor antagonist used to reduce stomach acid production and treat heartburn, not constipation. Loperamide is an antidiarrheal agent and would be contraindicated in a client experiencing constipation.

2. A nurse is assessing a client who is receiving packed RBCs. Which of the following findings indicate fluid overload?

• A. Low back pain
• B. Dyspnea
• C. Hypotension
• D. Thready pulse

Correct answer: B

Rationale: The correct answer is B: Dyspnea. Dyspnea, or difficulty breathing, is a common sign of fluid overload in a client receiving packed RBCs. When fluid accumulates in the lungs due to overload, it can lead to respiratory distress. This finding requires prompt intervention to prevent further complications. Choices A, C, and D are incorrect: A) Low back pain is not typically associated with fluid overload; C) Hypotension refers to low blood pressure and is not a typical finding in fluid overload; D) Thready pulse may indicate poor perfusion but is not a direct indicator of fluid overload.

3. A patient is being cared for by a nurse who has a history of angina and is experiencing chest pain. Which of the following actions should the nurse take first?

• A. Administer oxygen at 2 L/min via nasal cannula.
• B. Administer nitroglycerin sublingually.
• C. Obtain a 12-lead ECG.
• D. Notify the healthcare provider.

Correct answer: C

Rationale: In a patient with a history of angina experiencing chest pain, the priority action for the nurse is to obtain a 12-lead ECG. This helps in assessing for myocardial infarction, a serious condition that requires immediate attention. Administering oxygen, nitroglycerin, or notifying the healthcare provider can be important interventions but obtaining the ECG comes first to determine the presence of myocardial infarction and guide further management.

4. How should a healthcare provider manage a patient who is experiencing acute pain?

• A. Administer analgesics as prescribed
• B. Reposition the patient to alleviate pain
• C. Offer non-pharmacological interventions
• D. Administer IV fluids

Correct answer: A

Rationale: Corrected Rationale: Administering prescribed analgesics is the most effective way to manage acute pain. Analgesics help in reducing or eliminating pain quickly and efficiently. Repositioning the patient may be helpful in certain cases to relieve discomfort, but it is not the primary intervention for managing acute pain. Non-pharmacological interventions can be beneficial as adjuncts to pain management, but in cases of acute pain, administering analgesics is the priority. Administering IV fluids may be necessary for certain conditions but is not the primary intervention for managing acute pain.

5. What is the primary purpose of administering insulin to a patient with diabetes?

• A. Regulate blood glucose levels
• B. Increase metabolism
• C. Prevent complications
• D. Promote insulin sensitivity

Correct answer: A

Rationale: The correct answer is A: 'Regulate blood glucose levels.' Administering insulin to a patient with diabetes helps regulate blood glucose levels by facilitating the uptake of glucose into cells, thereby lowering high blood sugar levels. This process aims to prevent hyperglycemia and its associated complications. Choice B, 'Increase metabolism,' is incorrect as the primary role of insulin is not to increase metabolism directly. Choice C, 'Prevent complications,' is partially correct as regulating blood glucose through insulin administration does help prevent complications associated with uncontrolled diabetes, but it is not the primary purpose. Choice D, 'Promote insulin sensitivity,' is incorrect as insulin itself is administered to compensate for the lack of endogenous insulin in diabetic patients, rather than to promote sensitivity to it.

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