Nursing Elites

1. A patient with rheumatoid arthritis is taking prednisone. What is an important side effect for the nurse to monitor?

• A. Hyperglycemia
• B. Bradycardia
• C. Hypotension
• D. Hyperkalemia

Correct answer: A

Rationale: The correct answer is hyperglycemia. Prednisone, a corticosteroid, can lead to elevated blood sugar levels as a side effect, particularly in patients with diabetes or those predisposed to developing diabetes. Monitoring for hyperglycemia is crucial to prevent complications like diabetic ketoacidosis and hyperglycemic hyperosmolar syndrome.

2. When teaching a client postoperative breathing techniques with an incentive spirometer (IS), what should the nurse encourage the client to do to maintain sustained maximal inspiration?

• A. Exhale forcefully into the tubing for 3 to 5 seconds.
• B. Inspire deeply and slowly over 3 to 5 seconds.
• C. Breathe into the spirometer using normal breath volumes.
• D. Perform IS breathing exercises every 6 hours.

Correct answer: B

Rationale: To maintain sustained maximal inspiration when using an incentive spirometer, the client should be encouraged to inspire deeply and slowly over 3 to 5 seconds. This technique aids in achieving the goal of sustained maximal inspiration, which is essential for postoperative respiratory recovery.

3. A client with diabetes has a new prescription for 14 units of regular insulin and 28 units of NPH insulin subcutaneously at breakfast daily. What is the total number of units of insulin that should be prepared in the insulin syringe?

• A. 42 units
• B. 14 units
• C. 28 units
• D. 32 units

Correct answer: A

Rationale: To calculate the total number of units of insulin, you need to add the 14 units of regular insulin to the 28 units of NPH insulin, which equals 42 units. Therefore, the nurse should prepare 42 units of insulin in the syringe for the client.

4. What skin care instructions should the nurse give to a patient receiving external beam radiation therapy for cancer treatment?

• A. Use a heating pad to relieve any pain in the treated area.
• B. Apply alcohol-based lotions to the treated area daily.
• C. Avoid exposing the treated area to sunlight.
• D. Wash the treated area with hot water and strong soap.

Correct answer: C

Rationale: Patients undergoing external beam radiation therapy should be advised to avoid exposing the treated area to sunlight to prevent further skin damage. Heat sources like heating pads should be avoided to prevent burns and irritation to the skin. Alcohol-based lotions can be irritating to the skin and are not recommended. Washing the treated area with lukewarm water and mild soap is preferable to maintain skin integrity and prevent irritation. Therefore, the correct instruction for the patient is to avoid exposing the treated area to sunlight.

5. What should the nurse include in patient teaching for a patient prescribed ceftriaxone for bacterial pneumonia?

• A. Take the medication as prescribed.
• B. Expect urine color changes.
• C. Complete the full course of the antibiotic.
• D. Avoid dairy products during treatment.

Correct answer: C

Rationale: When educating a patient prescribed ceftriaxone for bacterial pneumonia, it is crucial to emphasize completing the full course of the antibiotic. Completing the full course helps ensure the infection is completely eradicated and reduces the risk of antibiotic resistance. Incomplete courses of antibiotics can lead to treatment failure and the development of resistant bacterial strains. Therefore, it is essential for patients to adhere to the prescribed treatment regimen to achieve optimal outcomes.

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