Nursing Elites

1. A healthcare provider is caring for a client with severe preeclampsia. Which of the following medications should the healthcare provider anticipate administering?

• A. Magnesium sulfate
• B. Oxytocin
• C. Misoprostol
• D. Nifedipine

Correct answer: A

Rationale: Magnesium sulfate is the correct answer as it is administered to prevent seizures in clients with severe preeclampsia. It acts as a central nervous system depressant and is the first-line treatment for eclampsia prevention. Oxytocin (Choice B) is used to induce or augment labor, not indicated specifically for preeclampsia. Misoprostol (Choice C) is used for labor induction and postpartum hemorrhage, not typically indicated for preeclampsia. Nifedipine (Choice D) is a calcium channel blocker used for managing hypertension in pregnancy but is not the first-line treatment for preventing seizures in severe preeclampsia.

2. A nurse is caring for a client who has a nasogastric (NG) tube and is receiving enteral feedings. The client reports feeling nauseated. Which of the following actions should the nurse take first?

• A. Administer an antiemetic.
• B. Check the client’s bowel sounds.
• C. Slow the rate of the feeding.
• D. Place the client in a supine position.

Correct answer: B

Rationale: The correct action for the nurse to take first when a client with a nasogastric tube reports feeling nauseated is to check the client's bowel sounds. This assessment helps the nurse evaluate for possible complications, such as a blockage or decreased gastric motility, that could be causing the nausea. Administering an antiemetic (Choice A) should not be the first action without assessing the underlying cause of the nausea. Slowing the rate of the feeding (Choice C) may be appropriate but is not the priority until further assessment is done. Placing the client in a supine position (Choice D) is not typically indicated for managing nausea in this situation.

3. A home health nurse is providing teaching to a patient who has a new diagnosis of a gastric ulcer and a new prescription for sucralfate oral suspension. What statement by the patient indicates an understanding of the teaching?

• A. I will take this medicine with meals.
• B. I will take this medicine right before bed.
• C. I will take this medicine 1 hour before meals and at bedtime.
• D. I will take this medicine only when I have symptoms.

Correct answer: C

Rationale: The correct answer is C because sucralfate should be taken on an empty stomach, 1 hour before meals, and at bedtime to coat the ulcer and protect it from stomach acid. Choice A is incorrect because taking it with meals may reduce its effectiveness. Choice B is incorrect as it should not be taken right before bed. Choice D is incorrect as sucralfate should be taken regularly as prescribed, not just when symptoms occur.

4. A nurse is reviewing the laboratory results for a client who has end-stage liver disease. Which of the following findings should the nurse expect?

• A. Elevated albumin
• B. Elevated ammonia
• C. Decreased total bilirubin
• D. Decreased prothrombin time

Correct answer: B

Rationale: In end-stage liver disease, the liver's inability to convert ammonia into urea leads to elevated ammonia levels. Elevated ammonia levels can result in hepatic encephalopathy, a serious complication. Therefore, the correct answer is B. Elevated albumin (Choice A) is not typically seen in end-stage liver disease as liver dysfunction often leads to decreased albumin levels. Decreased total bilirubin (Choice C) is unlikely in end-stage liver disease, as bilirubin levels tend to be elevated due to impaired liver function. Decreased prothrombin time (Choice D) is also not expected in end-stage liver disease, as impaired liver function results in prolonged prothrombin time.

5. A client with chronic renal failure needs dietary instructions. Which of the following should the nurse provide?

• A. Increase calcium intake
• B. Provide a diet high in potassium
• C. Restrict protein intake
• D. Increase fluid intake

Correct answer: C

Rationale: The correct answer is to instruct the client to restrict protein intake. In chronic renal failure, the kidneys are unable to effectively filter waste products, so limiting protein helps reduce the buildup of waste in the body. Increasing calcium intake (Choice A) is not typically necessary unless there is a specific deficiency. Providing a diet high in potassium (Choice B) is contraindicated as potassium levels need to be monitored and controlled in renal failure. Increasing fluid intake (Choice D) may be necessary depending on the individual's condition, but restricting protein intake is a more critical dietary instruction for clients with chronic renal failure.

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