Nursing Elites

1. A nurse is caring for a client who is in preterm labor and is receiving magnesium sulfate via IV infusion. Which of the following findings indicates magnesium toxicity?

• A. Blood glucose of 150 mg/dL
• B. Urine output of 20 mL/hour
• C. Systolic blood pressure of 140 mm Hg
• D. BUN 20 mg/dL

Correct answer: B

Rationale: The correct answer is B. A urine output of 20 mL/hour is a sign of magnesium toxicity because decreased urine output can lead to accumulation of magnesium. Choices A, C, and D are not indicators of magnesium toxicity. Elevated blood glucose, high systolic blood pressure, and normal BUN levels do not specifically point towards magnesium toxicity.

2. A client has a new prescription for levothyroxine. What should the nurse teach the client?

• A. It should be taken at night
• B. Monitor for symptoms of hypothyroidism
• C. Take it with calcium supplements
• D. Take it on an empty stomach

Correct answer: D

Rationale: The correct answer is to take levothyroxine on an empty stomach. This is because levothyroxine should be taken in the morning on an empty stomach to ensure proper absorption. Option A is incorrect because levothyroxine is usually advised to be taken in the morning. Option B is not the priority teaching point as monitoring for hypothyroidism symptoms is ongoing care. Option C is incorrect as levothyroxine should not be taken with calcium supplements as they can interfere with its absorption.

3. A nurse is planning care for a client who has Parkinson’s disease and is at risk for aspiration. Which of the following actions should the nurse include in the plan of care?

• A. Encourage the client to eat thin liquids
• B. Instruct the client to tilt their head forward when swallowing
• C. Give the client large pieces of food
• D. Have the client lie down after meals

Correct answer: B

Rationale: The correct action the nurse should include in the plan of care for a client with Parkinson’s disease at risk for aspiration is to instruct the client to tilt their head forward when swallowing. This action helps protect the airway and reduces the risk of aspiration in clients with impaired swallowing, which is common in Parkinson’s disease. Encouraging the client to eat thin liquids (Choice A) can increase the risk of aspiration as they are harder to control during swallowing. Giving the client large pieces of food (Choice C) can also increase the risk of choking and aspiration. Having the client lie down after meals (Choice D) can further increase the risk of aspiration due to the potential for reflux. Therefore, the best action to prevent aspiration in this situation is to instruct the client to tilt their head forward when swallowing.

4. A nurse is planning to delegate client assignments to the assistive personnel. Which of the following tasks is appropriate for the nurse to delegate?

• A. Adjust the flow rate of the client’s oxygen tank
• B. Collect a urine sample
• C. Measure the client’s pain level
• D. Monitor blood glucose levels

Correct answer: B

Rationale: The correct answer is B: Collect a urine sample. Delegating this task to assistive personnel is appropriate as it falls within their scope of practice. Tasks like adjusting the flow rate of oxygen tanks, measuring pain levels, and monitoring blood glucose levels require clinical judgment and should be performed by a nurse. It is important for nurses to delegate tasks that align with the competencies of assistive personnel to ensure safe and effective patient care.

5. When a nurse is interviewing a client who is requesting oral contraceptives, which finding in the client’s history is a contraindication to combined oral contraceptives?

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

Correct answer: C

Rationale: The correct answer is C: Impaired liver function. Impaired liver function is a contraindication to the use of oral contraceptives because they are metabolized in the liver. Choices A, B, and D are incorrect. Thyroid disease, allergy to penicillin, and abnormal blood glucose levels are not contraindications to combined oral contraceptives.

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