Nursing Elites

1. A nurse is caring for a newborn who is 1 hour old and has a respiratory rate of 50 breaths per minute with periods of apnea lasting up to 10 seconds. Which of the following actions should the nurse take?

• A. Administer oxygen
• B. Stimulate the newborn
• C. Initiate positive pressure ventilation
• D. Continue routine monitoring

Correct answer: D

Rationale: A respiratory rate of 50 breaths per minute with occasional periods of apnea lasting less than 15 seconds is normal for a newborn. The nurse should continue routine monitoring unless the apneic periods become prolonged or the newborn shows signs of respiratory distress. Administering oxygen or initiating positive pressure ventilation is not indicated in this scenario as the newborn's respiratory rate and apneic episodes are within normal limits for their age. Stimulating the newborn is also unnecessary since the described parameters fall within the expected range for a 1-hour-old infant.

2. A client at 28 weeks of gestation is experiencing preterm labor. Which of the following medications should the nurse plan to administer?

• A. Oxytocin
• B. Nifedipine
• C. Dinoprostone
• D. Misoprostol

Correct answer: B

Rationale: Nifedipine is the correct choice in this scenario. It is a calcium channel blocker that helps suppress uterine contractions and halt preterm labor. Nifedipine is commonly used to manage preterm labor in pregnant women by relaxing the smooth muscle of the uterus. Oxytocin (Choice A) is used to induce or augment labor, not to inhibit contractions. Dinoprostone (Choice C) and Misoprostol (Choice D) are prostaglandins used for cervical ripening and induction of labor, not for stopping preterm labor.

3. A client is newly diagnosed with hypothyroidism and prescribed levothyroxine. Which of the following instructions should the nurse include?

• A. Take the medication with food.
• B. Take the medication in the evening.
• C. Take the medication on an empty stomach.
• D. Take the medication only when experiencing symptoms.

Correct answer: C

Rationale: The correct instruction is to take levothyroxine on an empty stomach. This is necessary for proper absorption and effectiveness of the medication. Taking it with food can interfere with absorption. Timing is also crucial; it is usually recommended to take levothyroxine in the morning to prevent potential interactions with food and other medications throughout the day. Taking the medication in the evening may lead to sleep disturbances. Lastly, waiting to take the medication only when symptoms occur is not appropriate as levothyroxine is typically taken regularly to maintain thyroid hormone levels within the body.

4. A nurse is providing discharge teaching to a client with heart failure and a prescription for furosemide 20 mg PO twice daily. Which of the following instructions should the nurse include in the teaching?

• A. Monitor for increased blood pressure
• B. Increase intake of high-potassium foods
• C. Expect an increase in swelling in the hands and feet
• D. Take the second dose at bedtime

Correct answer: B

Rationale: The correct answer is B: "Increase intake of high-potassium foods." Furosemide is a loop diuretic that can lead to hypokalemia, a condition characterized by low potassium levels. To prevent this adverse effect, the client should increase their intake of high-potassium foods. Choice A is incorrect because furosemide typically leads to decreased blood pressure, not increased. Choice C is incorrect because furosemide is used to reduce swelling, not increase it. Choice D is incorrect because the second dose of furosemide should be taken in the morning to prevent nocturia.

5. A client with heart failure who presents with dyspnea, bibasilar crackles, and frothy sputum should receive which dietary recommendation?

• A. Decrease protein intake.
• B. Reduce sodium intake.
• C. Increase fluid intake.
• D. Decrease calcium intake.

Correct answer: B

Rationale: The correct answer is to reduce sodium intake. In heart failure, excess sodium can lead to fluid retention, exacerbating symptoms like dyspnea, bibasilar crackles, and frothy sputum. Therefore, reducing sodium intake is crucial in managing heart failure. Decreasing protein intake is not typically recommended in heart failure management. Increasing fluid intake would worsen the condition by further contributing to fluid overload. Decreasing calcium intake is not directly related to managing heart failure symptoms such as dyspnea, bibasilar crackles, and frothy sputum.

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