Nursing Elites

1. A nurse is obtaining the medical history of a client who has a new prescription for isosorbide mononitrate. Which of the following should the nurse identify as a contraindication to this medication?

• A. Glaucoma
• B. Hypertension
• C. Polycythemia
• D. Migraine headaches

Correct answer: A

Rationale: Isosorbide mononitrate is contraindicated in clients with glaucoma due to its potential to increase intraocular pressure, which can exacerbate the condition. Hypertension, polycythemia, and migraine headaches are not contraindications for isosorbide mononitrate. In fact, isosorbide mononitrate is commonly used in the management of hypertension and certain types of angina.

2. A nurse is assessing a client who has a blood glucose level of 250 mg/dL. Which of the following clinical manifestations is associated with this finding?

• A. Confusion
• B. Thirst
• C. Diaphoresis
• D. Shakiness

Correct answer: B

Rationale: Corrected Detailed Rationale: A blood glucose level of 250 mg/dL indicates hyperglycemia. Thirst (polydipsia) is a common clinical manifestation associated with hyperglycemia. The body tries to compensate for the high blood sugar by increasing fluid intake. Confusion (choice A) is more commonly associated with hypoglycemia, not hyperglycemia. Diaphoresis (choice C) and shakiness (choice D) are typical manifestations of hypoglycemia, not hyperglycemia. Therefore, the correct answer is increased thirst (polydipsia) in response to the elevated blood glucose level.

3. A nurse is teaching a client about the use of levetiracetam. Which of the following should be included in the teaching?

• A. It can cause weight loss
• B. Monitor for mood changes
• C. It is an over-the-counter medication
• D. It has no side effects

Correct answer: B

Rationale: The correct answer is B. Levetiracetam can cause mood changes and behavioral side effects, so clients should be monitored for these effects. Choice A is incorrect because levetiracetam is not typically associated with weight loss. Choice C is incorrect as levetiracetam is a prescription medication, not available over the counter. Choice D is incorrect as all medications, including levetiracetam, have potential side effects.

4. What is the name of a legal document that instructs health care providers and family members about what life-sustaining treatment an individual wants if they are unable to make decisions?

• A. Do Not Resuscitate
• B. Informed consent
• C. Living will
• D. Durable power of attorney for health care

Correct answer: C

Rationale: The correct answer is C, 'Living will.' A living will is a legal document that outlines an individual's preferences for life-sustaining medical treatment if they become unable to make decisions. Choice A, 'Do Not Resuscitate,' specifically refers to a directive that instructs healthcare providers not to perform CPR. Choice B, 'Informed consent,' pertains to a patient's right to be informed about and consent to medical treatment. Choice D, 'Durable power of attorney for health care,' involves appointing someone to make healthcare decisions on behalf of an individual when they are unable to do so.

5. A nurse is teaching a client who is pregnant about the amniocentesis procedure. Which of the following statements should the nurse include in the teaching?

• A. You do not need to have a full bladder for the procedure
• B. You will not receive magnesium sulfate before the procedure
• C. The procedure will take longer than 30 minutes to complete
• D. You should report if you experience any contractions after the procedure

Correct answer: D

Rationale: The correct statement to include in the teaching about amniocentesis is that the client should report if they experience any contractions after the procedure. This is crucial because contractions could indicate preterm labor or other complications following the amniocentesis. Choices A and B are incorrect as a full bladder is not required for the procedure, and magnesium sulfate is not typically given before an amniocentesis. Choice C is incorrect as the procedure usually takes about 20-30 minutes to complete.

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