Nursing Elites

1. A healthcare provider is reviewing the medical records of a client with a prescription for combination oral contraceptives. Which of the following conditions is a contraindication?

• A. Hyperthyroidism
• B. Thrombophlebitis
• C. Diverticulosis
• D. Hypocalcemia

Correct answer: B

Rationale: Thrombophlebitis is a contraindication to combination oral contraceptives due to the increased risk of thromboembolic events. Hyperthyroidism, diverticulosis, and hypocalcemia are not contraindications to combination oral contraceptives. Hyperthyroidism may affect thyroid hormone levels but does not directly contraindicate oral contraceptives. Diverticulosis is a condition related to the digestive system and does not impact the use of oral contraceptives. Hypocalcemia, a low calcium level in the blood, is not a contraindication for oral contraceptives.

2. What is the correct method of administering insulin to a patient with diabetes?

• A. Administer subcutaneously
• B. Administer intramuscularly
• C. Administer intravenously
• D. Administer orally

Correct answer: A

Rationale: The correct method of administering insulin to a patient with diabetes is to administer it subcutaneously. Insulin is typically injected into the fatty tissue just below the skin, allowing for a slow and consistent absorption into the bloodstream. Administering insulin intramuscularly (Choice B) is not recommended as it can lead to unpredictable absorption rates and potential complications. Administering insulin intravenously (Choice C) is only done in specific medical settings and not for routine diabetes management. Administering insulin orally (Choice D) is ineffective as the stomach acid would break down the insulin before it can be absorbed.

3. A client has a new prescription for digoxin. Which of the following statements should the nurse include?

• A. You should take this medication on an empty stomach.
• B. You should avoid taking this medication with antacids.
• C. Take your pulse before taking this medication.
• D. You should contact your provider if you experience visual changes.

Correct answer: C

Rationale: The correct statement for the nurse to include when teaching a client about digoxin is to 'Take your pulse before taking this medication.' This is essential because clients taking digoxin need to monitor their pulse to detect signs of bradycardia, a common adverse effect of the medication. Option A is incorrect because digoxin is usually recommended to be taken with food to avoid gastrointestinal upset. Option B is incorrect because antacids can interfere with the absorption of digoxin. Option D is incorrect because contacting the provider for visual changes is important, but monitoring the pulse is crucial for digoxin administration.

4. A nurse is receiving change-of-shift report for a group of clients. Which of the following clients should the nurse plan to assess first?

• A. A client who has sinus arrhythmia and is receiving monitoring.
• B. A client who has a hip fracture and a new onset of tachypnea.
• C. A client who has epidural analgesia and weakness in the lower extremities.
• D. A client who has diabetes and a hemoglobin A1C of 6.8%.

Correct answer: B

Rationale: The correct answer is B because a new onset of tachypnea can indicate a respiratory complication, which requires immediate assessment. Sinus arrhythmia, epidural analgesia with weakness, and a hemoglobin A1C level of 6.8% in a client with diabetes do not pose immediate life-threatening concerns that require urgent assessment compared to the potential respiratory issues associated with tachypnea.

5. When digitally evacuating stool from a client with a fecal impaction, what action should the nurse take?

• A. Insert a lubricated gloved finger and advance along the rectal wall
• B. Apply lubricant and stimulate peristalsis
• C. Apply pressure to the abdomen to assist with removal
• D. Increase fluid intake before the procedure

Correct answer: A

Rationale: The correct action when digitally evacuating stool from a client with a fecal impaction is to insert a lubricated gloved finger and advance along the rectal wall. This technique helps prevent trauma to the client. Choice B is incorrect because stimulating peristalsis is not the appropriate action for digitally evacuating stool. Choice C is incorrect as applying pressure to the abdomen can be uncomfortable and ineffective. Choice D is also incorrect because increasing fluid intake is not directly related to the digital evacuation procedure.

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