Nursing Elites

1. A nurse is providing teaching to a client who is at 28 weeks of gestation and is scheduled for a glucose tolerance test. Which of the following instructions should the nurse include?

• A. You should avoid consuming any food or drink for 8 hours before the test.
• B. You should drink 8 oz of water 1 hour before the test.
• C. You should take an antacid before the test.
• D. You should drink a glass of milk 1 hour before the test.

Correct answer: A

Rationale: Clients should avoid consuming any food or drink for 8 hours before the glucose tolerance test to ensure accurate results. Choice A is the correct instruction for the client preparing for a glucose tolerance test. Drinking water, taking an antacid, or consuming milk before the test can interfere with the accuracy of the results. Water or any other substance might affect the concentration of glucose in the blood, leading to inaccurate test results. Antacids and milk can also interfere with the test outcome. Therefore, the client should follow the instruction to fast for 8 hours before the test.

2. Which medication is commonly prescribed for patients with atrial fibrillation?

• A. Warfarin
• B. Digoxin
• C. Aspirin
• D. Lisinopril

Correct answer: B

Rationale: Digoxin is commonly prescribed to manage atrial fibrillation by controlling heart rate. While Warfarin is used to prevent blood clots, it is not primarily used for controlling heart rate in atrial fibrillation. Aspirin is not the first-line treatment for atrial fibrillation and is generally not recommended for rhythm control. Lisinopril is an ACE inhibitor used to treat high blood pressure and heart failure, but it is not typically prescribed as the primary medication for managing atrial fibrillation.

3. A nurse is planning care for a client who has chronic obstructive pulmonary disease (COPD). Which of the following actions should the nurse take?

• A. Encourage the client to increase physical activity.
• B. Place the client in the Trendelenburg position.
• C. Limit the client's fluid intake to prevent fluid overload.
• D. Administer high-flow oxygen via mask.

Correct answer: A

Rationale: The correct action for the nurse to take when caring for a client with COPD is to encourage the client to increase physical activity. Increased physical activity helps manage COPD symptoms by improving lung function and preventing deconditioning. Placing the client in the Trendelenburg position is not recommended for COPD as it can worsen breathing difficulties. Limiting fluid intake to prevent fluid overload is not typically necessary in COPD unless the client has comorbid conditions that require fluid restriction. Administering high-flow oxygen via mask may be necessary for COPD clients with severe hypoxemia, but it is not the initial action for planning care.

4. A nurse is preparing to perform tracheostomy care for a client. Which of the following actions should the nurse take first?

• A. Apply a sterile dressing.
• B. Suction the tracheostomy.
• C. Remove the inner cannula.
• D. Clean the stoma with sterile saline.

Correct answer: B

Rationale: Suctioning the tracheostomy should be performed first to clear the airway of secretions and ensure proper oxygenation before proceeding with other care. This helps maintain a patent airway and prevent complications such as aspiration. Applying a sterile dressing, removing the inner cannula, or cleaning the stoma can follow after ensuring adequate airway clearance through suctioning.

5. A nurse is caring for a client who has a new prescription for spironolactone. Which of the following laboratory values should the nurse monitor to evaluate the effectiveness of the medication?

• A. Serum sodium.
• B. Serum calcium.
• C. Serum potassium.
• D. Serum glucose.

Correct answer: C

Rationale: Corrected Rationale: Spironolactone is a potassium-sparing diuretic, so serum potassium should be monitored to evaluate its effectiveness. Monitoring serum potassium levels is crucial because spironolactone can cause hyperkalemia as a side effect. Serum sodium, serum calcium, and serum glucose levels are not directly affected by spironolactone and would not provide an accurate assessment of the medication's effectiveness.

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