Nursing Elites

1. A client with tuberculosis is starting medication therapy with isoniazid, rifampin, and pyrazinamide. Which of the following instructions should the nurse include?

• A. Take isoniazid with an antacid.
• B. Provide a sputum specimen every 2 weeks to the clinic for testing.
• C. Expect your sputum cultures to be negative after 6 months of therapy.
• D. Drink at least 8 ounces of water when you take the pyrazinamide tablet.

Correct answer: D

Rationale: Pyrazinamide can cause gastrointestinal upset and is best taken with a full glass of water to minimize irritation to the stomach lining. This instruction helps reduce the risk of adverse effects associated with pyrazinamide. Options A and C are not directly related to the medication regimen for tuberculosis. While sputum testing is important, the frequency mentioned in option B is not required every two weeks.

2. A nurse is interested in providing community education and screening on hypertension. In order to reach a priority population, to what target audience should the nurse provide this service?

• A. African American churches
• B. Asian American groceries
• C. High school sports camps
• D. Women's health clinics

Correct answer: A

Rationale: The correct answer is African American churches. African Americans in the United States have one of the highest rates of hypertension globally. By providing services at African American churches, the nurse can effectively reach this priority population. While hypertension education and screening are essential for all groups, African Americans are the priority population for this intervention due to their disproportionately high rates of hypertension.

3. A client is prescribed prednisone for asthma management. Which statement by the client indicates a need for further teaching?

• A. I will take this medication every day to prevent asthma attacks.
• B. I will avoid people with infections while taking this medication.
• C. I will take this medication with food to prevent stomach upset.
• D. I will stop taking this medication if I feel fine.

Correct answer: D

Rationale: The correct answer is D because prednisone, a corticosteroid, should not be abruptly stopped. It must be tapered off gradually to prevent adrenal insufficiency. Choices A, B, and C demonstrate proper understanding of the medication's use and side effects, emphasizing the importance of daily intake, infection prevention, and taking it with food to avoid stomach upset.

4. A healthcare professional is assessing a client with left-sided heart failure. Which finding is most commonly associated with this condition?

• A. Peripheral edema
• B. Jugular vein distention
• C. Hepatomegaly
• D. Crackles in the lungs

Correct answer: D

Rationale: Crackles in the lungs are commonly associated with left-sided heart failure due to pulmonary congestion. Left-sided heart failure leads to the backup of blood into the lungs, causing fluid leakage into the alveoli, which results in the characteristic crackling sound upon auscultation.

5. While suctioning the endotracheal tube of a client on a ventilator, the nurse notices an increase in the client's heart rate from 86/min to 110/min, with irregularity. What should the nurse do next?

• A. Obtain a cardiology consult.
• B. Suction the client less frequently.
• C. Administer an antidysrhythmic medication.
• D. Perform pre-oxygenation prior to suctioning.

Correct answer: D

Rationale: When a client's heart rate increases and becomes irregular during suctioning of an endotracheal tube, it indicates potential hypoxemia. Performing pre-oxygenation before suctioning helps prevent hypoxemia and subsequent dysrhythmias. This intervention ensures that the client has adequate oxygen reserves before the procedure, reducing the risk of complications related to suctioning.

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