Nursing Elites

1. A nurse is providing discharge teaching to a client who has a new prescription for clopidogrel. Which of the following instructions should the nurse include?

• A. Avoid eating foods that are high in fat.
• B. Monitor for black, tarry stools while taking this medication.
• C. Avoid taking this medication with grapefruit juice.
• D. Take this medication on an empty stomach.

Correct answer: B

Rationale: The correct instruction for the nurse to include is to advise the client to monitor for black, tarry stools while taking clopidogrel. This is important because it helps detect gastrointestinal bleeding, a potential side effect of the medication. Choice A is incorrect as there is no specific requirement to avoid foods high in fat while taking clopidogrel. Choice C is incorrect as grapefruit juice interaction is not a concern with clopidogrel. Choice D is incorrect as clopidogrel can be taken with or without food.

2. What is the appropriate nursing action for a patient experiencing an acute allergic reaction?

• A. Administer antihistamines
• B. Administer corticosteroids
• C. Administer oxygen
• D. Administer bronchodilators

Correct answer: A

Rationale: The appropriate nursing action for a patient experiencing an acute allergic reaction is to administer antihistamines. Antihistamines work by blocking the action of histamine, a chemical released during an allergic reaction, and can help relieve symptoms such as itching, swelling, and hives. Corticosteroids are used for severe allergic reactions not responding to antihistamines, as they have anti-inflammatory properties. Oxygen is administered in cases of respiratory distress, while bronchodilators are used for bronchospasms. However, the first-line intervention for an acute allergic reaction is antihistamines.

3. What is the first intervention when a patient has difficulty breathing post-surgery?

• A. Administer oxygen
• B. Reposition the patient
• C. Check oxygen saturation
• D. Elevate the head of the bed

Correct answer: A

Rationale: Administering oxygen is the initial intervention for a patient experiencing breathing difficulties post-surgery. Providing oxygen helps improve oxygenation and alleviate respiratory distress. Repositioning the patient, checking oxygen saturation, and elevating the head of the bed are important interventions but administering oxygen takes precedence in addressing hypoxia and respiratory compromise.

4. A client is receiving discharge teaching for a new prescription of metformin. Which of the following client statements demonstrates an understanding of the teaching?

• A. I will take this medication with my meals.
• B. I will take this medication at the same time every day.
• C. I will avoid drinking alcohol while taking this medication.
• D. I will expect to experience weight gain while taking this medication.

Correct answer: C

Rationale: The correct answer is C because clients taking metformin should avoid alcohol as it increases the risk of lactic acidosis. Choices A, B, and D are incorrect. Choice A is not specific to metformin but rather a general recommendation for some medications. Choice B is a good practice for medication adherence but does not relate specifically to metformin. Choice D is inaccurate as weight gain is not an expected side effect of metformin.

5. A nurse is assessing a client in active labor. The FHR baseline has been 100/min for 15 minutes. What condition should the nurse suspect?

• A. Maternal fever.
• B. Fetal anemia.
• C. Maternal hypoglycemia.
• D. Chorioamnionitis.

Correct answer: C

Rationale: In this scenario, with a fetal heart rate (FHR) baseline of 100/min for 15 minutes, the nurse should suspect maternal hypoglycemia. Maternal hypoglycemia can result in fetal bradycardia, which is defined as an FHR less than 110 beats per minute. Maternal hypoglycemia requires prompt intervention to prevent adverse outcomes for both the mother and the fetus. Maternal fever (Choice A) typically presents with tachycardia rather than bradycardia in the fetus. Fetal anemia (Choice B) is more likely to present with other signs such as pallor or tachycardia rather than bradycardia. Chorioamnionitis (Choice D) is characterized by maternal fever, uterine tenderness, and foul-smelling amniotic fluid, but it is not directly linked to the FHR baseline being 100/min.

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