Nursing Elites

1. A nurse is caring for a client who is receiving magnesium sulfate for preeclampsia. Which of the following findings should the nurse report to the healthcare provider?

• A. Urinary output of 40 mL/hr
• B. Respiratory rate of 10 breaths per minute
• C. Absent deep tendon reflexes
• D. Blood pressure of 150/90 mm Hg

Correct answer: B

Rationale: Magnesium sulfate can depress the central nervous system, leading to respiratory depression. A respiratory rate of 10 breaths per minute is below the normal range and requires immediate intervention. Urinary output of 40 mL/hr (Choice A) is within the normal range for a client receiving magnesium sulfate. Absent deep tendon reflexes (Choice C) are an expected finding due to the medication's effect on neuromuscular excitability. A blood pressure of 150/90 mm Hg (Choice D) is slightly elevated but not a priority concern compared to severe respiratory depression.

2. A patient is receiving discharge teaching for esophageal cancer and starting radiation therapy. What instruction should the healthcare provider include?

• A. Remove dye markings after each radiation treatment
• B. Apply a warm compress to the irradiated site
• C. Wear clothing over the area of radiation treatment
• D. Use a washcloth to bathe the treatment area

Correct answer: C

Rationale: The correct instruction for a patient starting radiation therapy for esophageal cancer is to wear clothing over the area of radiation treatment. This helps to prevent irritation and protect the skin. Removing dye markings after each treatment (choice A) is unnecessary and not typically part of the patient's self-care. Applying a warm compress (choice B) can exacerbate skin irritation caused by radiation. Using a washcloth to bathe the treatment area (choice D) can potentially irritate the skin further, making it important to avoid.

3. A nurse is assessing a client for signs of heart failure. Which of the following findings should the nurse monitor?

• A. Decreased heart rate
• B. Peripheral edema
• C. Increased energy levels
• D. Hyperglycemia

Correct answer: B

Rationale: The correct answer is B: Peripheral edema. Peripheral edema, the accumulation of fluid causing swelling in the extremities, is a classic sign of heart failure due to fluid overload. This occurs because the heart's reduced pumping efficiency leads to fluid backup in the circulatory system. Choices A, C, and D are incorrect. Decreased heart rate is not typically associated with heart failure; instead, tachycardia or an increased heart rate may be observed. Increased energy levels are not an expected finding in heart failure, as this condition often causes fatigue and weakness. Hyperglycemia is not a direct sign of heart failure; however, it can be present in individuals with uncontrolled diabetes or as a result of certain treatments, but it is not a specific indicator of heart failure.

4. A nurse is completing a dietary assessment for a client who observes kosher dietary practices. Which of the following behaviors should the nurse expect?

• A. Leavened bread may be eaten during Passover
• B. Shellfish is commonly consumed in the diet
• C. Meat and dairy products are eaten separately
• D. Fasting from meat occurs during Hanukkah

Correct answer: C

Rationale: The correct answer is C: 'Meat and dairy products are eaten separately.' In kosher dietary practices, it is essential to keep meat and dairy products separate. Mixing meat and dairy is prohibited, and there are specific guidelines for the preparation and consumption of each. Choices A, B, and D are incorrect. Choice A is wrong because leavened bread is not eaten during Passover in kosher practices. Choice B is incorrect as shellfish is not consumed in a kosher diet. Choice D is also inaccurate as fasting from meat does not occur during Hanukkah in kosher dietary practices.

5. A community nurse is instructing a group of high school students about the transmission of hepatitis A. Which mode of transmission should the nurse include in the teaching?

• A. Sexual contact
• B. Airborne droplets
• C. Fecal-oral
• D. Bloodborne

Correct answer: C

Rationale: The correct answer is C: Fecal-oral. Hepatitis A is primarily transmitted through the fecal-oral route, often from consuming contaminated food or water. Choice A, sexual contact, is not a typical mode of transmission for hepatitis A. Choice B, airborne droplets, is more characteristic of diseases like influenza or tuberculosis. Choice D, bloodborne transmission, is more relevant to hepatitis B and C, not hepatitis A.

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