Nursing Elites

1. A nurse is providing discharge instructions for a client after surgery. Which of the following should be included?

• A. Resume normal activities immediately
• B. Monitor for signs of infection
• C. Avoid all physical activity for 1 month
• D. Take pain medications only as needed

Correct answer: B

Rationale: The correct answer is B: 'Monitor for signs of infection.' After surgery, it is essential for clients to watch for signs of infection, such as increased redness, swelling, or drainage at the incision site. Choice A is incorrect because resuming normal activities immediately after surgery can be harmful. Choice C is incorrect as complete avoidance of physical activity for a month is typically not necessary and can lead to complications like blood clots. Choice D is incorrect as taking pain medications only as needed may not provide adequate pain management post-surgery.

2. A newly licensed nurse tells a charge nurse he is unsure about accepting telephone medication prescriptions. Which of the following providers should the charge nurse identify as having the legal ability to give telephone medication prescriptions?

• A. Nurse midwives
• B. Physical therapists
• C. Pharmacists
• D. Physician assistants

Correct answer: D

Rationale: Physician assistants are healthcare providers who are licensed to prescribe medications. They have the legal ability to give telephone orders for medications. Nurse midwives primarily focus on providing prenatal care and assisting during labor and delivery. Physical therapists specialize in rehabilitation services. Pharmacists dispense medications and provide medication counseling. Therefore, among the options provided, physician assistants are the correct choice for giving telephone medication prescriptions.

3. A nurse in an emergency department is serving on a committee that is reviewing the facility protocol for disaster readiness. The nurse should recommend that the protocol include which of the following as a clinical manifestation of smallpox?

• A. Bloody diarrhea
• B. Ptosis of the eyelids
• C. Descending paralysis
• D. Rash in the mouth

Correct answer: D

Rationale: The correct answer is D, 'Rash in the mouth.' Smallpox presents with a distinctive rash that typically begins in the mouth and spreads to the rest of the body, developing into pustules. This rash is a key clinical manifestation of smallpox. This infectious disease is characterized by the rash, fever, and other systemic symptoms. Choices A, B, and C are incorrect because they are not associated with smallpox. Bloody diarrhea, ptosis of the eyelids, and descending paralysis are not typical clinical manifestations of smallpox.

4. A nurse has provided education to a client regarding prescribed levothyroxine sodium. Which of the following client statements demonstrates understanding of medication administration?

• A. I should take the medication in the morning to prevent insomnia.
• B. I can take the medication at night before bed.
• C. I will stop the medication if I start to feel better.
• D. I will take the medication only when I feel symptoms.

Correct answer: A

Rationale: The correct answer is A. Levothyroxine should be taken in the morning on an empty stomach to prevent insomnia and ensure proper absorption of the medication. Choice B is incorrect because taking levothyroxine at night may interfere with sleep and absorption. Choice C is incorrect as stopping the medication without consulting the healthcare provider can lead to negative health outcomes. Choice D is incorrect because levothyroxine is a daily medication that should be taken consistently, not just when symptoms are present.

5. A nurse is caring for a client who has a prescription for a narcotic medication. After administration, the nurse is left with an unused portion. What should the nurse do?

• A. Discard the medication in the trash
• B. Return the medication to the pharmacy
• C. Discard the medication with another nurse as a witness
• D. Store the medication for future use

Correct answer: C

Rationale: The correct action for the nurse to take when left with an unused portion of a narcotic medication is to discard the medication with another nurse as a witness. This procedure ensures accountability and proper disposal of controlled substances. Choice A is incorrect as discarding in the trash can lead to potential misuse or environmental harm. Choice B is incorrect because returning controlled substances to the pharmacy is not the appropriate method for disposal. Choice D is incorrect as storing the medication for future use is not permitted with controlled substances.

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