Nursing Elites

1. A healthcare professional is preparing to administer metoprolol 200 mg PO daily. The medication available is metoprolol 100 mg/tablet. How many tablets should the healthcare professional administer? (Round the answer to the nearest whole number. Do not use a trailing zero.)

• A. 1 tablet
• B. 2 tablets
• C. 0.5 tablet
• D. 4 tablets

Correct answer: B

Rationale: To administer 200 mg of metoprolol using 100 mg tablets, the healthcare professional should give 2 tablets. Each tablet contains 100 mg of metoprolol, so 2 tablets will provide the required 200 mg dose. Choice A is incorrect because 1 tablet would only provide 100 mg, which is insufficient. Choice C is incorrect as fractions of tablets are usually not used in practice to ensure accurate dosing. Choice D is incorrect as it would result in an overdose, providing 400 mg instead of the prescribed 200 mg.

2. A healthcare provider is caring for a client who has a heart murmur. The healthcare provider is preparing to auscultate the pulmonary valve. Over which of the following locations should the healthcare provider place the bell of the stethoscope?

• A. Second intercostal space at the left sternal border
• B. Fifth intercostal space at the midclavicular line
• C. Fourth intercostal space at the left sternal border
• D. Fifth intercostal space at the left anterior axillary line

Correct answer: A

Rationale: The correct location to auscultate the pulmonary valve is the second intercostal space at the left sternal border. This area is where the pulmonary valve can best be heard due to its anatomical position. Choice B, the fifth intercostal space at the midclavicular line, is the location for auscultating the mitral valve. Choice C, the fourth intercostal space at the left sternal border, is the area for the tricuspid valve. Choice D, the fifth intercostal space at the left anterior axillary line, is the site for listening to the mitral valve as well. Therefore, option A is the correct choice for auscultating the pulmonary valve.

3. During an abdominal examination, a nurse in a provider’s office determines that a client has abdominal distention. The protrusion is at midline, the skin over the area is taut, and the nurse notes no involvement of the flanks. Which of the following possible causes of distention should the nurse suspect?

• A. Fat
• B. Fluid
• C. Flatus
• D. Hernias

Correct answer: D

Rationale: The correct answer is 'Hernias.' Abdominal distention with a midline protrusion, taut skin, and no involvement of the flanks is characteristic of hernias. Hernias are caused by a weakness in the abdominal wall, allowing organs or tissues to protrude through. Fluid accumulation (ascites) typically presents with a more generalized distention, while fat accumulation may cause more diffuse distension rather than a focal midline protrusion. Flatus, or gas, would not typically present with a visible midline protrusion and taut skin like hernias.

4. A client with prostate cancer declines to discuss concerns after the provider discusses treatment options. What statement should the nurse make?

• A. I am available to talk if you should change your mind.
• B. It’s important to discuss your concerns with the provider.
• C. You need to make a decision about your treatment options.
• D. Your concerns will be addressed at a later time.

Correct answer: A

Rationale: Offering to talk later if the client changes their mind respects their current choice and keeps the dialogue open. Choice B is not the best response as it may pressure the client to share concerns. Choice C is incorrect as it imposes a decision on the client. Choice D does not acknowledge the client's feelings in the moment and postpones addressing concerns.

5. A client is lying on the bathroom floor after a nurse responds to a call light. Which of the following actions should the nurse take first?

• A. Check the client for injuries
• B. Move hazardous objects away from the client
• C. Notify the provider
• D. Ask the client to describe how she felt prior to the fall

Correct answer: A

Rationale: The nurse's priority in this situation is to assess the client for injuries. Checking for injuries first is crucial to determine the extent of harm caused by the fall and to provide immediate care. Moving hazardous objects can wait until the client's safety is ensured. Notifying the provider and asking the client about how she felt prior to the fall are important but are secondary to assessing for injuries in this urgent scenario. It is essential to address immediate physical needs before investigating the cause of the fall or notifying other healthcare team members.

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