Nursing Elites

1. Which is the most important safety measure when administering a medication through a patient’s central venous catheter (CVC)?

• A. Using a sterile technique
• B. Ensuring correct placement of the CVC
• C. Flushing the CVC with saline after administration
• D. Monitoring for signs of infection

Correct answer: B

Rationale: The most important safety measure when administering a medication through a patient’s central venous catheter (CVC) is ensuring the correct placement of the CVC. This is crucial to prevent complications such as extravasation, infection, or improper drug delivery. While using a sterile technique, flushing the CVC with saline after administration, and monitoring for signs of infection are all important aspects of CVC care, ensuring the correct placement of the catheter takes precedence as it directly impacts patient safety during medication administration.

2. The practical nurse is caring for a client whose urine drug screen is positive for cocaine. Which behavior is this client likely to exhibit during cocaine withdrawal?

• A. Elevated energy level
• B. Euphoria
• C. High self-esteem
• D. Powerful craving for more

Correct answer: D

Rationale: The correct answer is D: Powerful craving for more. During cocaine withdrawal, individuals often experience intense cravings for the drug, along with symptoms such as fatigue, depression, and anxiety. These cravings can be overpowering and lead to a strong desire to seek out more cocaine to alleviate the withdrawal symptoms. Choices A, B, and C are incorrect as elevated energy level, euphoria, and high self-esteem are more associated with the effects of cocaine rather than withdrawal symptoms. Withdrawal from cocaine is characterized by the opposite, such as fatigue, low mood, and intense cravings.

3. After administering pantoprazole to a client with gastroesophageal reflux disease (GERD), which statement by the client indicates to the nurse that the medication is producing the desired effect?

• A. After eating my meal, I did not experience any heartburn
• B. I have a great appetite and am feeling really hungry
• C. I should increase the amount of vitamin C in my diet
• D. While eating, I had no difficulty swallowing any of the foods

Correct answer: A

Rationale: The correct answer is A. Pantoprazole reduces stomach acid production, thus preventing the occurrence of heartburn after meals, which is a common symptom of GERD. Choice B is incorrect because an increased appetite and hunger are not indicators of the desired effect of pantoprazole. Choice C is unrelated to the medication's effect on GERD symptoms. Choice D is also incorrect because the absence of difficulty swallowing is not a specific indicator of pantoprazole's effectiveness in treating GERD.

4. What information should the PN collect during the admission assessment of a terminally ill client to an acute care facility?

• A. Name of the funeral home to contact
• B. Client's wishes regarding organ donation
• C. Contact information for the client's next of kin
• D. Health care proxy information

Correct answer: B

Rationale: Correct Answer: B. Understanding the client's wishes regarding organ donation is crucial as it aligns with end-of-life care preferences and ensures that the client's decisions are respected. While obtaining the name of a funeral home (Choice A) may be necessary, it is not typically part of the initial admission assessment. Contact information for the client's next of kin (Choice C) is important for communication but may not be directly related to the client's immediate end-of-life wishes. Health care proxy information (Choice D) is vital for decision-making if the client becomes incapacitated but may not be the primary focus during the initial admission assessment.

5. An older postoperative client has the nursing diagnosis 'impaired mobility related to fear of falling.' Which desired outcome best directs the PN's actions for the client?

• A. The client will ambulate with assistance every 4 hours
• B. The physical therapist will instruct the client in the use of a walker
• C. The client will use self-affirmation statements to decrease fear
• D. The PN will place a gait belt on the client prior to ambulation

Correct answer: C

Rationale: The correct answer is C. Using self-affirmation statements helps the client reduce fear and regain confidence in mobility, which is essential for improving impaired mobility. Choice A focuses more on the frequency of ambulation rather than addressing the fear of falling. Choice B involves the physical therapist and the use of a walker, which may not directly address the client's fear. Choice D is a safety measure but does not specifically target the client's fear of falling.

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