Nursing Elites

1. What is the priority nursing action for a patient with respiratory distress?

• A. Administer oxygen
• B. Reposition the patient
• C. Administer bronchodilators
• D. Provide chest physiotherapy

Correct answer: A

Rationale: The priority nursing action for a patient with respiratory distress is to administer oxygen. Oxygen therapy is crucial in improving oxygenation levels and relieving respiratory distress, making it the top priority intervention. Repositioning the patient, administering bronchodilators, or providing chest physiotherapy may be necessary interventions depending on the underlying cause, but ensuring adequate oxygen supply should take precedence in addressing respiratory distress.

2. A nurse is caring for a client who is experiencing acute alcohol withdrawal. Which of the following medications should the nurse plan to administer?

• A. Lorazepam
• B. Atenolol
• C. Naltrexone
• D. Methadone

Correct answer: A

Rationale: Lorazepam is the correct choice for managing acute alcohol withdrawal symptoms due to its effectiveness in controlling agitation and tremors associated with this condition. Atenolol (Choice B) is a beta-blocker mainly used for hypertension and angina, not for alcohol withdrawal symptoms. Naltrexone (Choice C) is used for alcohol dependence treatment by reducing cravings and the rewarding effects of alcohol, but it is not typically used in acute withdrawal situations. Methadone (Choice D) is an opioid agonist mainly used for opioid detoxification and maintenance therapy, not for alcohol withdrawal.

3. A nurse in an emergency department is assessing a client who reports ingesting thirty diazepam tablets and has a respiratory rate of 10/min. After securing the client's airway and initiating an IV, which of the following actions should the nurse do next?

• A. Monitor the client's IV site for thrombophlebitis
• B. Administer flumazenil to the client
• C. Evaluate the client for further suicidal behavior
• D. Initiate seizure precautions for the client

Correct answer: B

Rationale: Administering flumazenil is the priority to reverse the effects of diazepam overdose. Monitoring the IV site for thrombophlebitis (choice A) is important but not the next immediate action. Evaluating the client for further suicidal behavior (choice C) is important but not the priority at this moment. Initiating seizure precautions (choice D) is not the priority action in this scenario.

4. A nurse is assessing a client who has heart failure and is receiving digoxin. Which of the following findings should the nurse identify as an indication of digoxin toxicity?

• A. Bradycardia.
• B. Tachycardia.
• C. Nausea.
• D. Blurred vision.

Correct answer: D

Rationale: Corrected Rationale: Blurred vision is a classic sign of digoxin toxicity, indicating a potential overdose. It is crucial to recognize this symptom promptly and report it to the healthcare provider for immediate intervention. Bradycardia and nausea are common side effects of digoxin but not specific indicators of toxicity. Tachycardia is unlikely in digoxin toxicity since it usually causes a decrease in heart rate.

5. A client has a new prescription for metformin. Which of the following instructions should the nurse include?

• A. Take this medication at bedtime.
• B. Avoid drinking alcohol while taking this medication.
• C. Eat 3 large meals each day.
• D. Report any muscle pain to your provider.

Correct answer: B

Rationale: The correct instruction the nurse should include for a client prescribed metformin is to avoid drinking alcohol. Alcohol consumption while on metformin increases the risk of lactic acidosis, a serious condition. Taking metformin at bedtime (choice A) is not a standard instruction. Eating 3 large meals each day (choice C) is not specific to metformin use and may not be suitable for all individuals. Reporting muscle pain (choice D) is important but not directly related to metformin use.

Similar Questions