Nursing Elites

1. A client who is 24 weeks pregnant presents with a complaint of feeling dizzy when lying on her back. What is the best response by the nurse?

• A. Advise the client to lie on her side
• B. Encourage the client to drink more fluids
• C. Suggest the client elevate her legs when lying down
• D. Recommend the client take short walks throughout the day

Correct answer: A

Rationale: The correct answer is to advise the client to lie on her side. Lying on the side can prevent the compression of the vena cava, which can cause dizziness in pregnant women. Encouraging the client to drink more fluids (Choice B) may be beneficial for other conditions but is not the best response for dizziness when lying on her back. Suggesting the client elevate her legs when lying down (Choice C) is not directly related to the issue described by the client. Recommending the client take short walks throughout the day (Choice D) may be helpful for other pregnancy-related symptoms but is not the most appropriate action for dizziness when lying on her back.

2. A client with gastroesophageal reflux disease (GERD) is being taught about dietary modifications. What should be emphasized?

• A. Avoiding spicy and fatty foods
• B. Eating small, frequent meals
• C. Avoiding meals before bedtime
• D. All of the above

Correct answer: D

Rationale: In managing GERD, dietary modifications play a significant role. Avoiding spicy and fatty foods helps reduce irritation, while eating small, frequent meals prevents overeating, which can trigger reflux. Avoiding meals before bedtime allows for better digestion and reduces the likelihood of acid reflux during the night. Therefore, all of the options (A, B, and C) are crucial in managing GERD symptoms, making choice D the correct answer.

3. A client has a prescription for enteric-coated (EC) aspirin 325mg PO daily. The medication drawer contains one 325mg aspirin. What action should the nurse take?

• A. Contact the pharmacy and request the prescribed form of aspirin
• B. Instruct the client about the effects of the medication
• C. Administer the aspirin with a full glass of water or a small snack
• D. Withhold the aspirin until consulting with the healthcare provider

Correct answer: A

Rationale: The correct action for the nurse to take is to contact the pharmacy and request the prescribed form of aspirin. Enteric-coated medications are designed to dissolve in the intestine, not the stomach, to avoid irritation. Therefore, it is essential to ensure the client receives the correct form of aspirin as prescribed. Instructing the client about the effects of the medication (choice B) is not necessary at this point as the issue is related to the form of the aspirin. Administering the aspirin with a full glass of water or a small snack (choice C) is not appropriate as it does not address the need for the correct form of the medication. Withholding the aspirin (choice D) without consulting the healthcare provider is not advisable as it may lead to a delay in the client receiving the necessary medication.

4. A client with a diagnosis of hypothyroidism is prescribed levothyroxine (Synthroid). Which symptom should prompt the nurse to notify the healthcare provider?

• A. Weight gain.
• B. Bradycardia.
• C. Nervousness and tremors.
• D. Fatigue.

Correct answer: C

Rationale: The correct answer is C: 'Nervousness and tremors.' In a client with hypothyroidism prescribed levothyroxine, the development of nervousness and tremors may indicate hyperthyroidism, which can result from excessive dosing of levothyroxine. Therefore, the nurse should promptly notify the healthcare provider to adjust the medication dosage. Choices A, B, and D are incorrect because weight gain, bradycardia, and fatigue are more commonly associated with hypothyroidism itself, indicating that the levothyroxine therapy may not be effective enough, rather than being signs of excessive dosing.

5. What safety measure should be implemented when administering chemotherapy?

• A. Use protective gloves and gown
• B. Prepare the medication in a designated area
• C. Administer the medication at the appropriate rate
• D. Verify the two client identifiers

Correct answer: A

Rationale: When administering chemotherapy, it is crucial to use protective gloves and a gown to protect against exposure to hazardous drugs that can be harmful through skin contact. Choice B is incorrect because chemotherapy medication should be prepared in a designated area to prevent contamination and ensure accurate preparation. Choice C is incorrect as chemotherapy should be administered at the appropriate rate to ensure patient safety and avoid adverse effects. Choice D is incorrect as verifying client identifiers is important for medication administration in general but not a specific safety measure related to chemotherapy administration.

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