Nursing Elites

1. A nurse in a provider’s office is interviewing a client who is requesting an oral contraceptive. Which of the following findings in the client’s history is a contraindication to the use of combination oral contraceptives?

• A. Thyroid disease
• B. Allergy to penicillin
• C. Impaired liver function
• D. Abnormal blood glucose

Correct answer: C

Rationale: Impaired liver function is a contraindication to combination oral contraceptives. The liver metabolizes hormones, and any impairment can affect the metabolism of hormones, potentially leading to imbalances or toxicity. Thyroid disease, allergy to penicillin, and abnormal blood glucose levels are not contraindications to combination oral contraceptives.

2. A nurse is assessing a client who has a chest tube following a thoracotomy. Which of the following findings requires intervention by the nurse?

• A. Tidaling with spontaneous respirations
• B. Drainage collection chamber is 1/3 full
• C. 1 cm of water present in the water seal chamber
• D. Suction chamber pressure of -20 cm H2O

Correct answer: C

Rationale: The correct answer is C. There should be 2 cm of water in the water seal chamber of the chest tube system. A level of 1 cm may indicate a leak or compromised functionality that requires intervention. Choices A, B, and D are not findings that necessarily require immediate intervention. Tidaling with spontaneous respirations is an expected finding, the drainage collection chamber being 1/3 full is within normal limits, and a suction chamber pressure of -20 cm H2O indicates appropriate suction for chest drainage.

3. A healthcare professional is assessing a client for potential complications after surgery. Which of the following should the healthcare professional monitor for?

• A. Decreased urine output
• B. Increased appetite
• C. Improved mobility
• D. Normal temperature

Correct answer: A

Rationale: Corrected Rationale: Decreased urine output can indicate renal complications or dehydration, which are common post-surgical complications. Monitoring urine output is crucial for detecting early signs of kidney dysfunction or fluid imbalances. Increased appetite, improved mobility, and normal temperature are not typical signs of immediate post-surgical complications and would not be the priority for monitoring in this case.

4. A client has been prescribed vasopressin for the treatment of diabetes insipidus. What is the expected pharmacological action of this medication?

• A. To stimulate the pancreas to secrete insulin
• B. To slow the absorption of glucose in the intestine
• C. To increase reabsorption of water in the renal tubules
• D. To increase blood pressure

Correct answer: C

Rationale: The correct answer is C: To increase reabsorption of water in the renal tubules. Vasopressin mimics the action of antidiuretic hormone (ADH) by increasing the reabsorption of water in the renal tubules. This leads to decreased urine output, helping to manage symptoms of diabetes insipidus, which is characterized by excessive thirst and urination. Choices A, B, and D are incorrect. Vasopressin does not stimulate the pancreas to secrete insulin, slow the absorption of glucose in the intestine, or directly increase blood pressure.

5. Which of the following would increase a client's risk of ovarian cancer?

• A. History of fibroids
• B. Early menopause
• C. Endometriosis
• D. Polycystic ovary syndrome

Correct answer: C

Rationale: The correct answer is C, Endometriosis. Endometriosis is associated with an increased risk of developing ovarian cancer due to chronic inflammation and hormonal imbalances. The exact cause is not fully understood, but women with endometriosis should be monitored closely. Choices A, B, and D are incorrect as they are not directly linked to an increased risk of ovarian cancer. Fibroids, early menopause, and polycystic ovary syndrome do not have a known direct correlation with ovarian cancer risk.

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