Nursing Elites

1. A client who is at 36 weeks of gestation is scheduled for a nonstress test. Which of the following client statements indicates an understanding of the teaching?

• A. I should fast for 12 hours before the test.
• B. I should expect the test to take about 10 minutes.
• C. I should have a full bladder for this test.
• D. I will need to have my blood glucose checked before the test.

Correct answer: B

Rationale: The correct answer is B. The nonstress test takes about 10 minutes and evaluates fetal heart rate in response to fetal movement. Choice A is incorrect because fasting is not required for a nonstress test. Choice C is incorrect as a full bladder is not necessary for this test. Choice D is incorrect as blood glucose checking is not typically part of a nonstress test.

2. A nurse is providing teaching to a client who has a new prescription for prednisone. Which of the following client statements indicates an understanding of the teaching?

• A. I will avoid crowded places to reduce my risk of infection.
• B. I will take this medication on an empty stomach.
• C. I will stop taking this medication if I experience nausea.
• D. I will take this medication for 2 weeks and then stop.

Correct answer: A

Rationale: The correct answer is A: 'I will avoid crowded places to reduce my risk of infection.' When taking prednisone, clients should avoid crowded places to reduce the risk of infection due to its immunosuppressive effects. Choice B is incorrect because prednisone is usually taken with food to reduce stomach upset. Choice C is incorrect because clients should not stop taking prednisone abruptly, even if they experience nausea. Choice D is incorrect because prednisone should be tapered off gradually under healthcare provider guidance instead of being stopped abruptly after 2 weeks.

3. A nurse is caring for a client who has experienced a stroke and has aphasia. Which of the following communication strategies should the nurse use?

• A. Speak louder to help the client understand
• B. Speak using simple sentences and gestures
• C. Use a picture board to facilitate communication
• D. Have the client practice writing words down

Correct answer: C

Rationale: The correct answer is to use a picture board to facilitate communication. Aphasia can make it challenging for individuals to understand and use language. Using a picture board can help the client convey their needs and understand information more effectively. Speaking louder (A) may not be helpful as aphasia is not related to hearing loss. While speaking using simple sentences and gestures (B) can be beneficial, using a picture board (C) is a more concrete and visual method to support communication for individuals with aphasia. Having the client practice writing words down (D) may not be suitable if the client's expressive language skills are impaired due to aphasia.

4. A nurse is assessing a client who has a new diagnosis of heart failure. Which of the following findings should the nurse report to the provider?

• A. Heart rate of 90/min
• B. Serum potassium level of 4.0 mEq/L
• C. Weight gain of 2 kg (4.4 lb) in 2 days
• D. Heart rate of 76/min

Correct answer: C

Rationale: A weight gain of 2 kg (4.4 lb) in 2 days can indicate fluid retention, which is a sign of worsening heart failure and should be reported. This rapid weight gain suggests a fluid overload, putting the client at risk for complications. A heart rate of 90/min is slightly elevated but not as concerning as a sudden significant weight gain. The serum potassium level of 4.0 mEq/L is within the normal range and does not directly indicate worsening heart failure. A heart rate of 76/min is within the normal range and does not raise immediate concerns related to heart failure.

5. A nurse is caring for a client who is receiving warfarin therapy. Which of the following laboratory results indicates the need for an increase in the dose of warfarin?

• A. PT 28 seconds
• B. INR 1.2
• C. aPTT 40 seconds
• D. Fibrinogen 350 mg/dL

Correct answer: B

Rationale: An INR of 1.2 is below the therapeutic range for a client on warfarin, indicating inadequate anticoagulation. Therefore, the client would require an increase in the dose of warfarin to achieve the desired therapeutic effect. Choices A, C, and D are not indicative of the need for a dose increase in warfarin therapy. PT of 28 seconds is within the therapeutic range, aPTT of 40 seconds is also within the normal range, and fibrinogen level of 350 mg/dL does not provide information about the anticoagulant effect of warfarin.

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