Nursing Elites

1. The nurse is providing information regarding safety and accidental poisoning to a grandparent who will be taking custody of a 1-year-old grandchild. Which comment by the grandparent will cause the nurse to intervene?

• A. I should call 911 if my grandchild loses consciousness.
• B. Never induce vomiting if my grandchild drinks bleach.
• C. If my grandchild eats a plant, I should provide syrup of ipecac.
• D. The number for poison control is 800-222-1222.

Correct answer: C

Rationale: The correct answer is C. Administering syrup of ipecac is no longer recommended in cases of poisoning. This is because it can lead to complications and is not considered safe. The grandparent should be informed that syrup of ipecac should not be given to a child who has ingested a toxic substance. Choices A, B, and D provide accurate information regarding actions to take in case of poisoning, such as calling 911 if the child loses consciousness, not inducing vomiting if the child drinks bleach, and having the poison control number readily available.

2. The healthcare provider is assessing how a patient's pain is affecting mobility. Which assessment question is most appropriate?

• A. What activities, if any, has your pain prevented you from doing?
• B. When does your pain medication typically take effect on your pain?
• C. Would you please rate your pain on a scale from 0 to 10 for me?
• D. Have you considered working with a physical therapist?

Correct answer: A

Rationale: The most appropriate assessment question in this scenario is asking the patient, 'What activities, if any, has your pain prevented you from doing?' This question helps the healthcare provider understand how pain is impacting the patient's daily activities and mobility, providing valuable insight into the limitations caused by the pain. Choice B focuses on pain medication effectiveness, which is not directly related to mobility assessment. Choice C aims at pain intensity assessment but does not directly address mobility issues. Choice D suggests a solution rather than gathering information about the current impact of pain on mobility.

3. A healthcare provider is preparing to administer digoxin to a patient with heart failure. Which of the following lab results should be reviewed before administering the medication?

• A. Potassium level
• B. Calcium level
• C. Hemoglobin level
• D. White blood cell count

Correct answer: A

Rationale: The correct answer is A: Potassium level. Hypokalemia increases the risk of digoxin toxicity. Digoxin can potentiate the effects of low potassium levels, leading to life-threatening arrhythmias. Therefore, it is essential to review the patient's potassium level before administering digoxin. Choices B, C, and D are incorrect because calcium level, hemoglobin level, and white blood cell count are not directly related to the risk of digoxin toxicity.

4. A nurse suspects a colleague of diverting narcotics. What is the nurse's first course of action?

• A. Confront the colleague directly about the suspicion.
• B. Report the suspicion to the nurse manager.
• C. Ignore the situation unless there is clear evidence.
• D. Keep a record of the colleague's actions for future reference.

Correct answer: B

Rationale: The correct first course of action for a nurse suspecting a colleague of diverting narcotics is to report the suspicion to the nurse manager. Confronting the colleague directly may not be safe and could compromise the investigation. Ignoring the situation is not appropriate as it can pose risks to patient safety. Keeping a record of the colleague's actions is not the primary action to take when drug diversion is suspected; reporting to the nurse manager is crucial for proper investigation and ensuring patient safety.

5. A nurse is preparing to administer enoxaparin to a client. Which of the following actions should the nurse plan to take?

• A. Aspirate for a blood return before depressing the plunger
• B. Insert the needle at a 45-degree angle
• C. Administer the medication 2.54 cm (1 in) from the umbilicus
• D. The nurse should not expel the air bubble in the prefilled syringe

Correct answer: D

Rationale: The correct action when administering enoxaparin is not to expel the air bubble in the prefilled syringe. Expelling the air bubble may lead to the loss of medication and result in an incomplete dose. Aspirating for a blood return (Choice A) is not necessary for subcutaneous injections like enoxaparin. Inserting the needle at a 45-degree angle (Choice B) is not specific to administering enoxaparin. Administering the medication 2.54 cm (1 in) from the umbilicus (Choice C) is not a standard guideline for enoxaparin administration.

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