Nursing Elites

1. A nurse is collecting data from a client who is experiencing a situational crisis following the loss of a job. The client states, 'I don't think I can go through this again.' Which of the following actions is the nurse's priority?

• A. Determine if the client is experiencing psychotic thinking
• B. Determine the client's support system
• C. Ask how the client copes with stress
• D. Assess the client's vital signs

Correct answer: A

Rationale: The priority is to determine if the client is experiencing psychotic thinking or suicidal ideation. In this situation, the nurse needs to assess if the client is having distorted thoughts or losing touch with reality, which could pose an immediate risk to the client's safety. While determining the client's support system, asking how the client copes with stress, and assessing vital signs are important aspects of care, they are not the priority when there is a concern about potential psychotic thinking or suicidal ideation.

2. A nurse at a long-term care facility is transcribing new prescriptions for four clients. Which of the following prescriptions is accurately transcribed by the nurse?

• A. KCl 10 mEq PO once daily
• B. KCl 20 mEq PO once daily
• C. Potassium gluconate PO
• D. Potassium chloride 20 mEq PO every morning

Correct answer: D

Rationale: The correct answer is D because it accurately transcribes the prescription by specifying the medication (Potassium chloride), the dose (20 mEq), the route (PO for by mouth), and the frequency (every morning). Choice A is incorrect as it specifies a lower dose compared to the correct prescription. Choice B is incorrect due to an inaccurate dose. Choice C is incorrect as it lacks specificity regarding the type of potassium prescribed and the dose.

3. What are the key differences between hypoglycemia and hyperglycemia?

• A. Hypoglycemia: Sweating, trembling; Hyperglycemia: Frequent urination, thirst
• B. Hypoglycemia: Increased thirst; Hyperglycemia: Sweating, confusion
• C. Hypoglycemia: Increased appetite; Hyperglycemia: Blurred vision
• D. Hypoglycemia: Dizziness; Hyperglycemia: Low blood pressure

Correct answer: A

Rationale: Hypoglycemia typically presents with sweating and trembling, while hyperglycemia is characterized by frequent urination and thirst. Therefore, the correct key differences between hypoglycemia and hyperglycemia are that hypoglycemia includes symptoms like sweating and trembling, while hyperglycemia involves symptoms such as frequent urination and thirst. Choices B, C, and D are incorrect because they do not accurately represent the characteristic symptoms of hypoglycemia and hyperglycemia, as stated in the question.

4. A nurse is caring for a client who has severe preeclampsia and is receiving magnesium sulfate intravenously. The nurse discontinues the magnesium sulfate after the client displays toxicity. Which of the following actions should the nurse take?

• A. Position the client supine.
• B. Prepare an IV bolus of dextrose 5% in water.
• C. Administer methylergonovine IM.
• D. Administer calcium gluconate IV.

Correct answer: D

Rationale: In cases of magnesium sulfate toxicity, calcium gluconate is the antidote that should be administered promptly. Positioning the client supine (Choice A) is not the priority in this scenario. Administering dextrose 5% in water (Choice B) is not indicated for magnesium sulfate toxicity. Methylergonovine IM (Choice C) is used for postpartum hemorrhage, not for magnesium sulfate toxicity.

5. What are the key steps in administering oral medications to a patient with dysphagia?

• A. Crush medications and mix with food
• B. Use a straw to facilitate swallowing
• C. Encourage the patient to drink thickened liquids
• D. Have the patient lie flat during administration

Correct answer: A

Rationale: The correct answer is A: Crush medications and mix with food. When administering oral medications to a patient with dysphagia, crushing the medications and mixing them with food is a common method to aid in swallowing. Choice B is incorrect because using a straw could pose a choking hazard for patients with dysphagia. Choice C is incorrect as thickened liquids may not always be suitable for all medications. Choice D is incorrect because having the patient lie flat can increase the risk of aspiration, which is not recommended for patients with dysphagia.

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