Nursing Elites

1. A client is reviewing a new prescription for Terbutaline with a history of preterm labor. Which of the following client statements indicates understanding of the teaching?

• A. I can increase my activity now that I've started on this medication.
• B. I will increase my daily fluid intake to 3 quarts.
• C. I will report increasing intensity of contractions to my doctor.
• D. I am glad this will prevent preterm labor.

Correct answer: C

Rationale: The correct answer is C. The client should report increasing intensity, frequency, or duration of contractions to the provider as these are signs of preterm labor. Monitoring contractions is crucial for the management of preterm labor and the safety of both the client and the fetus. Choices A, B, and D are incorrect because increasing activity, fluid intake, or assuming the medication will prevent preterm labor do not address the essential need to report changes in contractions, which are a vital sign of potential complications in preterm labor.

2. A client asks a nurse about Feverfew. Which response should the nurse provide?

• A. It is used to treat skin infections.
• B. It can decrease the frequency of migraine headaches.
• C. It can lessen the nasal congestion in the common cold.
• D. It can relieve nausea of morning sickness during pregnancy.

Correct answer: B

Rationale: The correct response is B: 'It can decrease the frequency of migraine headaches.' Feverfew is known for reducing the frequency of migraine headaches, but it has not been proven to relieve an existing migraine headache. Choices A, C, and D are incorrect because Feverfew is not used to treat skin infections, lessen nasal congestion in the common cold, or relieve nausea of morning sickness during pregnancy.

3. A client is receiving combination chemotherapy. Which of the following findings should the nurse identify as an indication of an oncologic emergency?

• A. Dry oral mucous membranes
• B. Nausea and vomiting
• C. Temperature of 38.1°C (100.6°F)
• D. Anorexia

Correct answer: C

Rationale: A temperature of 38.1°C (100.6°F) can indicate an infection, which is considered an oncologic emergency in clients receiving chemotherapy due to the increased risk of sepsis in immunocompromised individuals. Dry oral mucous membranes (Choice A), nausea and vomiting (Choice B), and anorexia (Choice D) are common side effects of chemotherapy but do not typically indicate an oncologic emergency requiring immediate intervention.

4. A client has a new prescription for Valproic Acid. The client should be informed that which of the following laboratory tests need to be completed periodically? (Select all that apply.)

• A. Thrombocyte count.
• B. Hematocrit.
• C. Amylase.
• D. Liver function tests.

Correct answer: A

Rationale: Valproic acid can lead to thrombocytopenia, making it essential to monitor the client's thrombocyte count periodically. Additionally, valproic acid can cause pancreatitis, necessitating the monitoring of amylase levels. Furthermore, valproic acid carries a risk of hepatotoxicity, requiring regular monitoring of liver function tests.

5. A client with Addison's disease is being admitted for a total hip arthroplasty. The client takes hydrocortisone. What is the nurse's priority action?

• A. Administering a supplemental dose of hydrocortisone
• B. Instructing the client about coughing and deep breathing
• C. Collecting additional information from the client about his history of Addison's disease
• D. Inserting an indwelling urinary catheter

Correct answer: A

Rationale: The priority action for a client with Addison's disease undergoing surgery who takes hydrocortisone is to administer a supplemental dose of hydrocortisone. Acute adrenal insufficiency (adrenal crisis) is a significant risk during surgery due to the stress placed on the body. Supplemental doses help prevent acute adrenal insufficiency and ensure the client's safety during the surgical procedure. Instructing the client about coughing and deep breathing is important post-operatively but not the priority before surgery. Collecting additional information about the client's history of Addison's disease is relevant but not the priority action before surgery. Inserting an indwelling urinary catheter is not the priority action in this scenario.

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