Nursing Elites

1. What is the most appropriate action for a healthcare provider to take when a patient refuses a prescribed medication?

• A. Document the refusal and notify the healthcare provider.
• B. Administer the medication at a later time.
• C. Explain the importance of the medication and its effects.
• D. Respect the patient's right to refuse the medication.

Correct answer: D

Rationale: The correct answer is to respect the patient's right to refuse the medication. It is crucial to uphold the patient's autonomy and decision-making capacity when it comes to their treatment. Administering the medication later without the patient's consent (Choice B) disregards their autonomy and can lead to ethical issues. Documenting the refusal and notifying the healthcare provider (Choice A) is important for legal and continuity of care purposes but should come after respecting the patient's decision. While explaining the importance of the medication (Choice C) is valuable for promoting understanding and compliance, the immediate concern should be respecting the patient's refusal.

2. A client expresses concern about hair loss during chemotherapy. What should the nurse suggest?

• A. Encourage the client to cut their hair short before chemotherapy begins.
• B. Offer resources for wigs and head coverings.
• C. Assure the client that hair loss will be minimal.
• D. Ignore the client's concerns about hair loss.

Correct answer: B

Rationale: During chemotherapy, hair loss is a common side effect. Offering resources for wigs and head coverings can help the client cope with this change in appearance, maintain self-esteem, and feel more comfortable during the process. Encouraging the client to cut their hair short does not address the emotional impact of hair loss and may not be the client's preference. Assuring the client that hair loss will be minimal may provide false hope as significant hair loss is a common occurrence. Ignoring the client's concerns is not appropriate and goes against the principles of providing holistic and compassionate care.

3. A nurse is receiving change-of-shift report on a group of clients. Which of the following clients should the nurse assess first?

• A. A client who has urolithiasis and reports severe ankle pain extending toward the abdomen
• B. A client who has acute cholecystitis and reports abdominal pain radiating to the right shoulder
• C. A client who has had a total knee arthroplasty, is 1 day postoperative, and reports a pain level of 8 on a 0 to 10 pain scale
• D. A client who has a fractured femur and reports sudden sharp chest pain

Correct answer: D

Rationale: The correct answer is D because a client with a fractured femur and sudden chest pain may be experiencing a pulmonary embolism, which requires immediate assessment. Choice A is incorrect because although severe pain is present, it is more indicative of musculoskeletal issues related to urolithiasis rather than a life-threatening condition. Choice B, related to acute cholecystitis, is less urgent than choice D as the pain radiating to the right shoulder is a common symptom but does not indicate an immediate life-threatening situation. Choice C, regarding a client post-total knee arthroplasty with a pain level of 8, is important but not as urgent as a potential pulmonary embolism in choice D.

4. A client in her first trimester of pregnancy is being taught by a nurse about over-the-counter medications that belong to pregnancy risk category B. Which of the following medications should the nurse include?

• A. Naproxen
• B. Aspirin
• C. Ibuprofen
• D. Acetaminophen

Correct answer: D

Rationale: Acetaminophen is the correct choice as it belongs to pregnancy risk category B, making it considered safe during pregnancy. Naproxen, Aspirin, and Ibuprofen are not recommended during pregnancy, especially in the first trimester, as they are classified in higher-risk categories which may be harmful to the developing fetus.

5. Which intervention is most effective for managing a patient with constipation?

• A. Increase the patient's fluid intake.
• B. Administer a stool softener as prescribed.
• C. Provide the patient with a high-fiber diet.
• D. Teach the patient to perform Valsalva maneuvers.

Correct answer: B

Rationale: The most effective intervention for managing constipation in a patient is to administer a stool softener as prescribed. Stool softeners help relieve constipation by making the stool easier to pass, especially in postoperative patients. Increasing fluid intake can be beneficial but may not address the underlying cause of constipation. While a high-fiber diet is important for bowel health, it may not provide immediate relief for constipation. Teaching a patient to perform Valsalva maneuvers is not recommended for managing constipation as it can lead to adverse effects like increasing intra-abdominal pressure.

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