Nursing Elites

1. A client is undergoing preparation for extensive colorectal surgery. Which of the following oral antibiotics should be administered to suppress normal flora in the GI tract?

• A. Kanamycin
• B. Gentamicin
• C. Neomycin
• D. Tobramycin

Correct answer: C

Rationale: The correct answer is C: Neomycin. Neomycin, an aminoglycoside antibiotic, is administered orally before GI surgery to eliminate the normal flora in the large intestine. This helps reduce the risk of postoperative infections by decreasing the bacterial load in the gut. Choices A, B, and D (Kanamycin, Gentamicin, Tobramycin) are not typically used to suppress normal flora in the GI tract before colorectal surgery.

2. A client has a new prescription for Albuterol and Beclomethasone inhalers for the control of asthma. Which of the following instructions should the nurse include in the teaching?

• A. Take the albuterol at the same time each day.
• B. Administer the albuterol inhaler before using the beclomethasone inhaler.
• C. Use beclomethasone if experiencing an acute episode.
• D. Avoid shaking the beclomethasone before use.

Correct answer: B

Rationale: When a client is prescribed an inhaled beta2-agonist (such as albuterol) and an inhaled glucocorticoid (such as beclomethasone) for asthma control, the beta2-agonist should be administered first. Administering the beta2-agonist before the glucocorticoid helps promote bronchodilation and enhances the absorption of the glucocorticoid, maximizing its effectiveness in the lungs. Choice A is incorrect because albuterol is usually taken as needed for quick relief of asthma symptoms and not necessarily at the same time each day. Choice C is incorrect as beclomethasone is a controller medication used for long-term asthma management, not for acute episodes. Choice D is incorrect as shaking the beclomethasone inhaler before use helps ensure proper medication dispersion for effective inhalation.

3. A client has a new prescription for erythromycin. Which of the following statements by the client indicates an understanding of the teaching?

• A. I should take this medication with a full glass of water.
• B. I should avoid direct sunlight while taking this medication.
• C. I will take this medication on an empty stomach.
• D. I should take an antacid 30 minutes before taking this medication.

Correct answer: C

Rationale: The correct answer is C. Erythromycin should be taken on an empty stomach with a full glass of water to increase absorption. Taking it with a full glass of water (Choice A) is incorrect. Avoiding direct sunlight (Choice B) is not related to erythromycin use. Taking an antacid before the medication (Choice D) can interfere with its absorption.

4. A client in labor is receiving IV Opioid analgesics. Which of the following actions should the nurse take?

• A. Instruct the client to self-ambulate every 2 hours.
• B. Offer oral hygiene every 2 hours.
• C. Anticipate medication administration 2 hours prior to delivery.
• D. Monitor fetal heart rate every 2 hours.

Correct answer: B

Rationale: When a client is receiving IV Opioid analgesics during labor, the nurse should offer oral hygiene every 2 hours. Opioid analgesics can cause adverse effects like dry mouth, nausea, and vomiting. Providing oral hygiene care helps alleviate these symptoms and maintains the client's comfort and well-being during labor. Instructing the client to self-ambulate every 2 hours is not appropriate during labor as mobility may be limited. Anticipating medication administration 2 hours prior to delivery is not necessary as the timing of medication administration should be based on the client's needs and the progress of labor. Monitoring fetal heart rate every 2 hours is important during labor, but it is not specifically related to the client receiving IV Opioid analgesics.

5. A client is being taught by a healthcare professional about preventing Otitis Externa. Which of the following instructions should the healthcare professional include?

• A. Clean the ear with a cotton-tipped swab daily
• B. Place earplugs in the ears when sleeping at night
• C. Use a cool water irrigation solution to remove earwax
• D. Tip the head to the side to remove water from the ears after showering

Correct answer: D

Rationale: To prevent Otitis Externa, it is important to remove water from the ears after showering or swimming. This helps reduce the risk of moisture buildup in the ear canal, which can lead to infection. Cleaning the ear with a cotton-tipped swab daily can actually increase the risk of injury or infection. Placing earplugs in the ears when sleeping at night may trap moisture and promote bacterial growth. Using a cool water irrigation solution to remove earwax is not recommended as it can disrupt the natural balance of the ear canal.

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