Nursing Elites

1. A nurse is receiving change-of-shift report for four clients. Which of the following clients should the nurse see first?

• A. A client with pneumonia who had new onset of confusion
• B. A client with diabetes who had low blood sugar overnight
• C. A client with a leg fracture who needs pain medication
• D. A client whose urinary output was 100 mL for the past 12 hours

Correct answer: A

Rationale: The correct answer is A. New confusion in a client with pneumonia could indicate hypoxia or a worsening condition, requiring immediate attention. Option B, a client with diabetes having low blood sugar overnight, is a concerning condition but not as urgent as potential hypoxia. Option C, a client with a leg fracture needing pain medication, and option D, a client with decreased urinary output, are important but do not take precedence over addressing a potentially critical respiratory issue.

2. What are the key nursing interventions for a patient undergoing dialysis?

• A. Monitor fluid balance and administer heparin
• B. Monitor blood pressure and prevent clot formation
• C. Administer medications and monitor blood chemistry
• D. Provide dietary education and encourage protein intake

Correct answer: A

Rationale: The correct answer is A: Monitor fluid balance and administer heparin. For a patient undergoing dialysis, it is crucial to monitor fluid balance to prevent fluid overload or depletion. Administering heparin helps prevent clot formation during the dialysis process. Option B is incorrect as while monitoring blood pressure is essential, preventing clot formation is more directly related to heparin administration. Option C is incorrect because administering medications and monitoring blood chemistry are not the primary interventions for dialysis. Option D is incorrect as while dietary education and protein intake are important for overall health, they are not the key nursing interventions specifically for a patient undergoing dialysis.

3. How should a healthcare provider assess and manage a patient with a suspected urinary tract infection (UTI)?

• A. Antibiotic Therapy
• B. Hydration
• C. Pain Management
• D. Patient Education

Correct answer: A

Rationale: When assessing and managing a patient with a suspected UTI, the priority is to start antibiotic therapy to treat the infection. Antibiotics are crucial in eliminating the bacteria causing the UTI. While hydration is important to help flush out the bacteria, pain management can help alleviate discomfort but is not the primary treatment. Patient education is vital for prevention and management but is not the immediate intervention required for a suspected UTI.

4. A nurse is caring for a client with an NG tube who is experiencing nausea and decreased gastric secretions. What is the priority nursing action?

• A. Increase the suction pressure
• B. Turn the client onto their side
• C. Irrigate the NG tube with sterile water
• D. Replace the NG tube with a new one

Correct answer: D

Rationale: The correct answer is to replace the NG tube with a new one. When a client with an NG tube experiences nausea and decreased gastric secretions, it indicates a possible problem with the tube itself. Replacing the tube ensures proper functioning and can alleviate the symptoms. Increasing the suction pressure (Choice A) can worsen the client's condition. Turning the client onto their side (Choice B) may be helpful in some situations but does not address the underlying issue. Irrigating the NG tube with sterile water (Choice C) is not the priority and may not resolve the problem.

5. A patient took an overdose of acetaminophen. Which of the following medications should the nurse plan to administer to the patient?

• A. Naloxone
• B. Acetylcysteine
• C. Flumazenil
• D. Activated charcoal

Correct answer: B

Rationale: Acetylcysteine is the antidote for acetaminophen overdose. It works by replenishing glutathione, a key component in detoxifying acetaminophen metabolites, thus preventing liver damage. Naloxone is used to reverse opioid overdose, not acetaminophen. Flumazenil is a benzodiazepine antidote. Activated charcoal is used to limit absorption in cases of poisoning, but it is not the antidote for acetaminophen overdose.

Similar Questions