Nursing Elites

1. The healthcare provider should observe most closely for drug toxicity when a client receives a medication that has which characteristic?

• A. Low bioavailability
• B. Rapid onset of action
• C. Short half-life
• D. Narrow therapeutic index

Correct answer: D

Rationale: The correct answer is D, narrow therapeutic index. Narrow therapeutic index (NTI) drugs are defined as those drugs where small differences in dose or blood concentration may lead to serious therapeutic failures or adverse drug reactions. Choices A, B, and C are not directly related to the risk of drug toxicity. Low bioavailability (Choice A) refers to the amount of drug that enters the bloodstream unchanged after administration. Rapid onset of action (Choice B) and short half-life (Choice C) are characteristics related to drug effectiveness and metabolism but do not necessarily indicate a higher risk of drug toxicity.

2. A client who is taking an oral dose of a tetracycline complains of gastrointestinal upset. What snack should the nurse instruct the client to take with the tetracycline?

• A. Fruit-flavored yogurt
• B. Cheese and crackers
• C. Cold cereal with skim milk
• D. Toasted wheat bread and jelly

Correct answer: D

Rationale: The correct answer is D: Toasted wheat bread and jelly. Dairy products decrease the effect of tetracycline, so the nurse should instruct the client to avoid them. Toast, which contains no dairy products, may help decrease gastrointestinal symptoms. Choices A, B, and C contain dairy products, which should be avoided when taking tetracycline.

3. A male client with an antisocial personality disorder is admitted to an inpatient mental health unit for multiple substance dependencies. When providing a history, the client justifies to the nurse his use of illicit drugs. Based on this pattern of behavior, this client's history is most likely to include which finding?

• A. Multiple convictions for misdemeanors and class B felonies.
• B. A history of stable employment
• C. Strong relationships with family members
• D. A pattern of seeking help when needed

Correct answer: A

Rationale: The correct answer is A: Multiple convictions for misdemeanors and class B felonies. Clients with antisocial personality disorder often engage in behaviors that disregard societal rules and norms, leading to legal issues and criminal activities. This behavior is characteristic of individuals with antisocial personality disorder. Choices B, C, and D are incorrect because individuals with this disorder are less likely to have stable employment, strong family relationships, or seek help when needed due to their pattern of defiance and disregard for authority and rules.

4. An adolescent's mother calls the clinic because the teen is having recurrent vomiting and has become combative in the last 2 days. The mother states that the teen takes vitamins, calcium, magnesium, and aspirin. Which nursing intervention has the highest priority?

• A. Advise the mother to withhold all medications by mouth.
• B. Instruct the mother to take the teen to the emergency room.
• C. Recommend that the teen withhold food and fluids for 2 hours.
• D. Suggest that the adolescent breathe slowly and deeply.

Correct answer: B

Rationale: The correct answer is to instruct the mother to take the teen to the emergency room. The symptoms described, including recurrent vomiting and becoming combative after taking vitamins, calcium, magnesium, and aspirin, indicate a potential overdose or a serious condition. Therefore, immediate medical evaluation in the emergency room is crucial. Advising to withhold all medications by mouth (Choice A) may delay necessary treatment. Recommending to withhold food and fluids (Choice C) is not appropriate in this urgent situation. Suggesting deep breathing (Choice D) does not address the seriousness of the symptoms and the need for immediate medical attention.

5. Which needle should the nurse use to administer intravenous fluids (IV) via a client's implanted port?

• A. The one with the clamp and no needle
• B. A butterfly needle
• C. A non-coring (Huber) needle
• D. A standard hypodermic needle

Correct answer: C

Rationale: The correct needle to use for administering intravenous fluids via an implanted port is a non-coring (Huber) needle. This type of needle is specifically designed to access implanted ports without coring the septum, which helps prevent damage. Choice A, the one with the clamp and no needle, is incorrect as it does not describe a needle suitable for accessing an implanted port. Choice B, a butterfly needle, is not typically used for accessing implanted ports. Choice D, a standard hypodermic needle, is not ideal for accessing ports as it can damage the septum.

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