Nursing Elites

1. The nurse is preparing to administer the first dose of an antibiotic to a patient admitted for a urinary tract infection. Which action is most important prior to administering the antibiotic?

• A. Administering a small test dose to determine if hypersensitivity exists
• B. Having epinephrine available in case of a severe hypersensitivity reaction
• C. Monitoring baseline vital signs, including temperature and blood pressure
• D. Obtaining a specimen for culture and sensitivity

Correct answer: D

Rationale: The most crucial action before administering an antibiotic for a urinary tract infection is to obtain a specimen for culture and sensitivity. This ensures the accurate identification of the causative organism and helps determine the most effective antibiotic therapy. Administering a test dose to detect hypersensitivity is usually reserved for cases with a strong suspicion of allergy to a needed antibiotic. Keeping epinephrine available is important when there is a significant risk of a severe allergic reaction. Monitoring baseline vital signs is essential during antibiotic therapy but is not the top priority before administering the first dose.

2. The nurse is caring for a client who is scheduled for hemodialysis. Which of the following laboratory values should the nurse monitor closely before, during, and after the procedure?

• A. Hemoglobin level.
• B. Blood urea nitrogen (BUN) level.
• C. Creatinine level.
• D. Serum potassium level.

Correct answer: D

Rationale: The correct answer is D: Serum potassium level. Before, during, and after hemodialysis, monitoring the serum potassium level is crucial to prevent hyperkalemia, a potentially life-threatening complication. Hemodialysis is done to remove waste products and excess electrolytes like potassium from the blood. Monitoring other laboratory values like hemoglobin, BUN, and creatinine is important in assessing kidney function and anemia, but serum potassium level requires close monitoring during hemodialysis due to the risk of rapid shifts that can lead to cardiac arrhythmias.

3. The client with diabetes mellitus is being taught how to prevent or delay chronic kidney disease (CKD). Which client statements indicate a lack of understanding of the teaching? (Select all that apply.)

• A. I can continue to take an aspirin every 4 to 8 hours for my pain.
• B. My weight should be maintained at a body mass index of 30.
• C. Smoking should be stopped as soon as possible.
• D. A & B

Correct answer: D

Rationale: The correct answer is D. Both statements A and B indicate a lack of understanding of CKD prevention. Taking aspirin every 4 to 8 hours can lead to kidney damage, and maintaining a body mass index (BMI) of 30 is considered overweight, which can increase the risk of developing CKD. Statement C, on the other hand, correctly addresses smoking cessation, which is crucial in preventing CKD. Therefore, choices A and B are incorrect as they do not align with CKD prevention strategies, making option D the correct choice.

4. Which of the following interventions is most appropriate for a patient with acute pancreatitis?

• A. Administering oral fluids.
• B. Administering IV fluids.
• C. Administering analgesics.
• D. Encouraging the patient to ambulate.

Correct answer: B

Rationale: The most appropriate intervention for a patient with acute pancreatitis is administering IV fluids. IV fluid administration is crucial in managing acute pancreatitis as it helps maintain hydration, correct electrolyte imbalances, and prevent shock. Administering oral fluids (Choice A) may not be sufficient to address the fluid loss and maintain hydration in these patients. While analgesics (Choice C) are important for pain management in pancreatitis, addressing hydration and shock prevention takes precedence. Encouraging the patient to ambulate (Choice D) may be beneficial in some cases for preventing complications like deep vein thrombosis, but it is not the primary intervention needed in the acute phase of pancreatitis.

5. A patient is diagnosed with Mycoplasma pneumonia. Which antibiotic will the nurse expect the provider to order to treat this infection?

• A. Azithromycin (Zithromax)
• B. Clarithromycin (Biaxin)
• C. Erythromycin (E-Mycin)
• D. Fidaxomicin (Dificid)

Correct answer: C

Rationale: Erythromycin is the drug of choice for treating Mycoplasma pneumonia. Mycoplasma pneumonia is typically sensitive to macrolide antibiotics, with erythromycin being one of the first-line agents. Azithromycin and clarithromycin are also effective in treating Mycoplasma pneumonia, but erythromycin is specifically mentioned as the drug of choice in this context. Fidaxomicin, on the other hand, is not indicated for the treatment of Mycoplasma pneumonia and is primarily used to treat Clostridium difficile infections.

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