Nursing Elites

1. A nurse has provided education to a client regarding prescribed levothyroxine sodium. Which of the following client statements demonstrates understanding of medication administration?

• A. I should take the medication in the morning to prevent insomnia.
• B. I can take the medication at night before bed.
• C. I will stop the medication if I start to feel better.
• D. I will take the medication only when I feel symptoms.

Correct answer: A

Rationale: The correct answer is A. Levothyroxine should be taken in the morning on an empty stomach to prevent insomnia and ensure proper absorption of the medication. Choice B is incorrect because taking levothyroxine at night may interfere with sleep and absorption. Choice C is incorrect as stopping the medication without consulting the healthcare provider can lead to negative health outcomes. Choice D is incorrect because levothyroxine is a daily medication that should be taken consistently, not just when symptoms are present.

2. A healthcare provider is discussing recommendations for daily nutrient intake during pregnancy with a client who is at 10 weeks of gestation. For which of the following nutrients should the healthcare provider instruct the client to increase intake during pregnancy?

• A. Vitamin E
• B. Vitamin D
• C. Fiber
• D. Calcium

Correct answer: D

Rationale: The correct answer is D: Calcium. During pregnancy, it is essential to increase calcium intake as it is crucial for fetal bone development and to prevent maternal bone loss. Adequate calcium supports the increased needs of both the mother and the developing baby. Vitamin E, Vitamin D, and fiber are also important nutrients, but the specific nutrient that needs to be increased during pregnancy for bone development is calcium. Vitamin E is an antioxidant that plays a role in protecting cells from damage, Vitamin D helps with calcium absorption and bone health, and fiber is important for digestive health but does not specifically need to be increased during pregnancy for bone development.

3. A nurse is assessing four clients for fluid balance. Which of the following clients is exhibiting manifestations of dehydration?

• A. A client who has a urine specific gravity of 1.010.
• B. A client who has a weight gain of 2.2 kg (2 lb) in 24 hr.
• C. A client who has a hematocrit of 45%.
• D. A client who has a temperature of 39°C (102°F).

Correct answer: D

Rationale: The correct answer is D because an elevated temperature is a common manifestation of dehydration. Choices A, B, and C are not indicative of dehydration. A urine specific gravity of 1.010 is within normal range, weight gain suggests fluid overload, and a hematocrit of 45% is also within normal limits and not specifically related to dehydration.

4. A nurse is performing a vaginal exam on a client who is in active labor. The nurse notes the umbilical cord protruding through the cervix. Which of the following actions should the nurse take?

• A. Administer oxytocin to the client via intravenous infusion
• B. Apply oxygen at 2 L/min via nasal cannula
• C. Prepare for insertion of an intrauterine pressure catheter
• D. Assist the client into the knee-chest position

Correct answer: D

Rationale: The nurse should assist the client into the knee-chest position to relieve pressure on the umbilical cord. This position helps to prevent cord compression and improves fetal oxygenation. Administering oxytocin (Choice A) could worsen the situation by increasing contractions and potentially compressing the umbilical cord. Applying oxygen (Choice B) is not the priority in this emergency situation. Preparing for insertion of an intrauterine pressure catheter (Choice C) is not appropriate as the immediate concern is relieving pressure on the umbilical cord.

5. A nurse is planning care for a newly admitted adolescent client who has bacterial meningitis. Which of the following instructions is appropriate for the nurse to include in the plan of care?

• A. Initiate droplet precautions
• B. Assist the client to a supine position
• C. Perform Glasgow Coma Scale assessment every 24 hours
• D. Recommend prophylactic acyclovir for the client’s family

Correct answer: A

Rationale: The correct answer is A: 'Initiate droplet precautions.' Bacterial meningitis requires droplet precautions to prevent the spread of infection, as the bacteria can be transmitted through respiratory secretions. Choice B is incorrect because assisting the client to a supine position is not specific to the care of a client with bacterial meningitis and may not be appropriate for all clients. Choice C is incorrect because while performing Glasgow Coma Scale assessments is important in managing clients with neurological conditions, it is not directly related to preventing the spread of bacterial meningitis. Choice D is incorrect because recommending prophylactic acyclovir for the client's family is not a standard precautionary measure for preventing the spread of bacterial meningitis.

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