Nursing Elites

1. A client is prescribed metronidazole for a bacterial infection. Which of the following should the nurse teach the client?

• A. Avoid alcohol while taking this medication
• B. It is safe to take during pregnancy
• C. Monitor for increased appetite
• D. It can cause hair loss

Correct answer: A

Rationale: The correct answer is A: 'Avoid alcohol while taking this medication.' Metronidazole can cause a disulfiram-like reaction with alcohol, leading to symptoms like nausea, vomiting, flushing, and headache. Therefore, clients should be instructed to avoid alcohol consumption. Choice B is incorrect because metronidazole is not considered safe during pregnancy, especially in the first trimester. Choice C is incorrect as metronidazole is not known to cause increased appetite. Choice D is also incorrect as hair loss is not a common side effect of metronidazole.

2. While caring for a client receiving oxytocin for labor augmentation, the nurse notes contractions occurring every 45 seconds and lasting 90 seconds. What should the nurse do?

• A. Discontinue the oxytocin infusion
• B. Increase the oxytocin infusion
• C. Apply an internal fetal monitor
• D. Administer an analgesic

Correct answer: A

Rationale: The correct action for the nurse to take in this situation is to discontinue the oxytocin infusion. The client is experiencing uterine hyperstimulation, which can lead to fetal distress and complications. By stopping the oxytocin, the nurse can help regulate contractions and prevent harm to the fetus. Increasing the oxytocin infusion would exacerbate the issue by further intensifying contractions. Applying an internal fetal monitor may be necessary for closer monitoring but is not the immediate action required. Administering an analgesic is not appropriate in this scenario as the primary concern is addressing the uterine hyperstimulation caused by oxytocin.

3. A client with diabetes mellitus is receiving education on foot care. Which of the following instructions should the nurse include?

• A. Apply lotion between the toes.
• B. Cut toenails straight across.
• C. Use a heating pad to warm the feet.
• D. Soak feet in warm water daily.

Correct answer: B

Rationale: The correct answer is B: Cut toenails straight across. This instruction is vital for clients with diabetes as it helps prevent ingrown toenails and infections, reducing the risk of foot ulcers. Applying lotion between the toes (choice A) should be avoided as it can create a moist environment prone to fungal infections. Using a heating pad (choice C) can lead to burns or injuries due to reduced sensation common in diabetes. Soaking feet in warm water daily (choice D) can also increase the risk of skin breakdown and should be avoided.

4. When providing education on the use of insulin, what should be included?

• A. Insulin can be stored at room temperature indefinitely
• B. Monitor blood glucose levels before administration
• C. Insulin is a long-acting medication
• D. Insulin has no side effects

Correct answer: B

Rationale: The correct answer is to monitor blood glucose levels before administration. This step is crucial to ensure the correct dose of insulin is administered based on the current blood glucose level. Choice A is incorrect as insulin usually needs to be stored in the refrigerator and has an expiration date. Choice C is incorrect because insulin can be short-acting, rapid-acting, intermediate-acting, or long-acting. Choice D is also incorrect as insulin can have side effects such as hypoglycemia if the dose is too high.

5. A nurse is preparing to administer ampicillin 500 mg in 50 mL of dextrose 5% in water (D5W) to infuse over 15 min. The drop factor of the manual IV tubing is 10 gtt/mL. How many gtt/min should the nurse set the manual IV infusion to deliver?

• A. 30 gtt/min
• B. 32 gtt/min
• C. 33 gtt/min
• D. 35 gtt/min

Correct answer: C

Rationale: Calculation: 10 gtt/mL × 50 mL ÷ 15 min = 33.33, rounded to 33 gtt/min. This ensures proper delivery of the medication over the prescribed time. Choice A is incorrect because it does not factor in the precise calculation based on the given data. Choice B is incorrect as it does not reflect the accurate rate of infusion required. Choice D is incorrect as it does not align with the correct calculation based on the drop factor and infusion parameters provided in the question.

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