Nursing Elites

1. How should a healthcare professional handle a patient who is refusing to take a prescribed medication?

• A. Immediately give the medication
• B. Assess the reasons for refusal
• C. Document refusal
• D. Explore alternative treatment options

Correct answer: B

Rationale: Assessing the reasons for refusal is crucial as it allows the healthcare professional to understand the patient's concerns, which can range from fear of side effects to cost issues. By identifying the underlying reasons, the healthcare professional can tailor their approach to address these specific concerns, potentially improving medication adherence. Giving the medication immediately (Choice A) without understanding the patient's reasons for refusal can lead to further non-compliance. While documenting refusal (Choice C) is important for legal and tracking purposes, it does not directly address the patient's concerns. Exploring alternative treatment options (Choice D) may be considered after understanding the reasons for refusal, but it is not the initial step in managing medication refusal.

2. A nurse is assessing a client who is receiving enteral nutrition via a nasogastric tube. Which of the following findings should the nurse report to the provider?

• A. Gastric pH of 2.5.
• B. Bowel sounds every 4 hours.
• C. Diarrhea of 250 mL in 24 hours.
• D. Gastric residual of 150 mL.

Correct answer: D

Rationale: A gastric residual of 150 mL may indicate delayed gastric emptying and should be reported to the provider.

3. What is the best position for a patient with respiratory distress?

• A. Semi-Fowler's position
• B. Trendelenburg position
• C. Prone position
• D. Supine position

Correct answer: A

Rationale: The best position for a patient with respiratory distress is the Semi-Fowler's position. This position promotes lung expansion and improves oxygenation by allowing the chest to expand more fully. The Trendelenburg position, where the patient's feet are higher than the head, is contraindicated in respiratory distress as it can increase pressure on the diaphragm and compromise breathing. The prone position, lying face down, may be beneficial in certain cases like acute respiratory distress syndrome but is not generally recommended for all patients in respiratory distress. The supine position, lying flat on the back, can worsen respiratory distress by causing the tongue to fall back and obstruct the airway.

4. A client with schizophrenia is beginning therapy with clozapine. Which statement indicates a need for further teaching?

• A. I will need to have my blood work checked regularly while taking clozapine.
• B. I understand that clozapine may cause me to gain weight.
• C. I should report any signs of a fever while taking clozapine.
• D. I should discontinue clozapine once my symptoms improve.

Correct answer: D

Rationale: The correct answer is D because clients should continue taking clozapine even if their symptoms improve. Abruptly discontinuing the medication can lead to relapse. Choices A, B, and C are all correct statements regarding clozapine therapy. Regular blood work monitoring is necessary due to potential side effects, weight gain is a common side effect of clozapine, and reporting signs of fever is important as it can indicate a serious side effect of clozapine.

5. How should a healthcare professional manage a patient with non-compliance to hypertension medication?

• A. Provide education on medication
• B. Refer the patient to a specialist
• C. Discontinue the medication
• D. Reassess the patient in 6 months

Correct answer: A

Rationale: Providing education on medication is crucial when managing a patient with non-compliance to hypertension medication. By educating the patient on the importance of adherence, potential side effects, and the impact of uncontrolled hypertension, healthcare professionals can help improve the patient's understanding and compliance. Referring the patient to a specialist (Choice B) may be necessary in some cases but should not be the first step. Discontinuing the medication (Choice C) without exploring reasons for non-compliance and providing education can worsen the patient's condition. Reassessing the patient in 6 months (Choice D) is important but should be accompanied by interventions to address non-compliance in the interim.

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