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. A client with a diagnosis of hypothermia is being admitted to the hospital by a nurse. Which of the following signs does the nurse anticipate that this client will exhibit?

• A. Increased heart rate and increased blood pressure
• B. Increased heart rate and decreased blood pressure
• C. Decreased heart rate and increased blood pressure
• D. Decreased heart rate and decreased blood pressure

Correct answer: D

Rationale: Hypothermia decreases the heart rate and blood pressure due to reduced metabolic needs of the body. With lower metabolic demands, the heart's workload decreases, leading to reductions in both heart rate and blood pressure. Choices A, B, and C are incorrect because hypothermia typically results in a decrease in heart rate and blood pressure, not an increase.

3. When providing care for an unconscious client who has seizures, which nursing intervention is most essential?

• A. Ensure oral suction is available.
• B. Maintain the client in a semi-Fowler's position.
• C. Provide frequent mouth care.
• D. Keep the room at a comfortable temperature.

Correct answer: A

Rationale: During seizures in an unconscious client, ensuring oral suction is available is crucial to managing secretions and preventing aspiration. This intervention helps maintain a clear airway and reduce the risk of complications. Maintaining the client in a semi-Fowler's position (Choice B) may be important for airway management but is not as critical as having oral suction ready. Providing frequent mouth care (Choice C) and keeping the room at a comfortable temperature (Choice D) are important aspects of overall care but are not as urgently needed as ensuring oral suction for managing secretions during seizures.

4. Which of the following is the best position for a patient experiencing dyspnea?

• A. Supine position.
• B. Fowler's position.
• C. Trendelenburg position.
• D. Lateral recumbent position.

Correct answer: B

Rationale: Fowler's position is the best position for a patient experiencing dyspnea. This position involves sitting the patient upright with the head of the bed elevated between 45-60 degrees. Fowler's position helps improve breathing in patients with dyspnea by promoting lung expansion, aiding in better oxygenation, and reducing the work of breathing. The supine position (Choice A) may worsen dyspnea by limiting lung expansion. The Trendelenburg position (Choice C) with the feet elevated and the head down is not recommended for dyspnea as it can increase pressure on the chest and compromise breathing. The lateral recumbent position (Choice D) is not ideal for dyspnea as it does not provide optimal lung expansion and may not alleviate breathing difficulty.

5. Which instruction should be included in the discharge teaching plan for a client who underwent cataract extraction today?

• A. Use a metal eye shield on the operative eye during the day.
• B. Administer eye ointment before applying eye drops.
• C. Sexual activities may be resumed after returning home.
• D. Light housekeeping is safe to do, but avoid heavy lifting.

Correct answer: D

Rationale: The correct instruction to include in the discharge teaching plan for a client who underwent cataract extraction is to advise them that light housekeeping is safe to do, but they should avoid heavy lifting. Heavy lifting can strain the surgical site and potentially lead to complications. Choice A is incorrect as a metal eye shield is usually recommended during sleep, not during the day. Choice B is incorrect because eye ointment should typically be administered after applying eye drops to prevent dilution of the medication. Choice C is incorrect as sexual activities should usually be avoided for a specific period post-surgery as advised by the healthcare provider.

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