Nursing Elites

1. A nurse is providing discharge teaching for a client prescribed warfarin. What should be included in the teaching?

• A. Avoid foods rich in vitamin K
• B. Take warfarin with meals
• C. Take aspirin for pain relief
• D. Report unusual bleeding or bruising

Correct answer: D

Rationale: The correct answer is D. When a client is prescribed warfarin, they should be educated to report any unusual bleeding or bruising promptly. Choices A, B, and C are incorrect. Avoiding foods rich in vitamin K is not necessary when taking warfarin, as long as intake remains consistent. Warfarin does not need to be taken with meals, and aspirin should not be taken for pain relief due to its blood-thinning effects, which can increase the risk of bleeding when combined with warfarin.

2. A nurse is preparing to administer a medication that requires a peak and trough level. What is the nurse's priority action?

• A. Administer the medication before the peak level is obtained.
• B. Withhold the medication until the trough level is obtained.
• C. Administer the medication based on the previous trough level.
• D. Ensure that the medication is administered within 2 hours of the peak level.

Correct answer: B

Rationale: The nurse's priority action should be to withhold the medication until the trough level is obtained. This is crucial to ensure accurate dosing based on the patient's levels. Administering the medication before the peak level is obtained (choice A) can lead to incorrect dosing. Administering the medication based on the previous trough level (choice C) may not reflect the current levels accurately. Ensuring that the medication is administered within 2 hours of the peak level (choice D) is not necessary for obtaining accurate peak and trough levels.

3. Which intervention is most effective in preventing postoperative complications?

• A. Encourage the patient to drink fluids.
• B. Ambulate the patient as soon as possible.
• C. Perform deep breathing exercises with the patient.
• D. Encourage the patient to perform range of motion exercises.

Correct answer: B

Rationale: The most effective intervention in preventing postoperative complications is to ambulate the patient as soon as possible. Early ambulation helps prevent complications like deep vein thrombosis and pneumonia by enhancing circulation and preventing respiratory issues. Encouraging the patient to drink fluids, perform deep breathing exercises, or range of motion exercises are beneficial interventions, but ambulation is the priority due to its overall impact on preventing various postoperative complications.

4. While reviewing notes from a previous shift, a nurse finds incomplete documentation. What is the most appropriate action?

• A. Complete the missing documentation
• B. Notify the nurse manager of the issue
• C. Ask the nurse to complete the documentation
• D. Confront the nurse about the incomplete notes

Correct answer: B

Rationale: The most appropriate action when finding incomplete documentation is to notify the nurse manager of the issue. This ensures that accurate records are maintained and the situation can be addressed properly. Completing the missing documentation on behalf of someone else may lead to inaccuracies, asking the nurse to complete it may not guarantee timely correction, and confronting the nurse could create a confrontational situation that is not conducive to effective teamwork.

5. A nurse is caring for a child who is allergic to penicillin. The nurse should verify which of the following prescriptions with the provider?

• A. Amphotericin B
• B. Amoxicillin-clavulanate
• C. Erythromycin
• D. Gentamicin

Correct answer: B

Rationale: Amoxicillin-clavulanate is related to penicillin, and a cross-sensitivity could occur, so the provider should be consulted.

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