Nursing Elites

1. A client who is at 36 weeks of gestation is being taught about nonstress testing. Which of the following statements should the nurse include in the teaching?

• A. This test will determine the length of your cervix.
• B. You will have your blood pressure taken frequently during the test.
• C. You should press the handheld button when you feel your baby move.
• D. This test will take about 5 minutes to complete.

Correct answer: C

Rationale: The correct answer is C. In a nonstress test, the client is required to press a handheld button whenever fetal movement is felt, which is then recorded on the monitor. This action helps assess the baby's heart rate in response to its movements, providing valuable information about the baby's well-being. Choices A, B, and D are incorrect because the nonstress test does not involve determining the length of the cervix, monitoring blood pressure, or being completed in 5 minutes. These aspects are not part of the nonstress testing procedure and are unrelated to the purpose of the test.

2. How should a healthcare provider manage care for a patient with a wound infection?

• A. Administer prescribed antibiotics
• B. Clean the wound with saline
• C. Apply a sterile dressing
• D. Monitor for signs of sepsis

Correct answer: A

Rationale: When managing care for a patient with a wound infection, administering prescribed antibiotics is crucial. Antibiotics are necessary to treat the infection and prevent it from worsening. While cleaning the wound with saline and applying a sterile dressing are important components of wound care, the primary treatment for a wound infection is antibiotics. Monitoring for signs of sepsis is also essential, but administering antibiotics promptly is the most critical step in managing a wound infection.

3. A nurse in a provider's office is collecting data from a preschooler. Which of the following findings should the nurse report to the provider?

• A. Heart rate 80/min
• B. Heart rate 90/min
• C. Respiratory rate 28/min
• D. Heart rate 146/min

Correct answer: D

Rationale: A heart rate of 146/min is abnormal for a preschooler and indicates tachycardia, which should be reported to the provider. Choices A, B, and C fall within normal ranges for a preschooler's heart rate (80-120/min) and respiratory rate (22-34/min), so they do not require immediate reporting. Option D is the correct answer as it deviates significantly from the normal range and may indicate an underlying health issue that needs attention.

4. When instructing a client with tuberculosis on home care, what is the priority teaching point?

• A. Wear a surgical mask at all times
• B. Limit visitors to two-hour increments
• C. Take medication for 6-9 months
• D. Take breaks during meals

Correct answer: C

Rationale: The correct answer is C: 'Take medication for 6-9 months.' The priority teaching point for a client with tuberculosis is to ensure they understand the importance of completing the entire course of medication. This is crucial to effectively treat and cure tuberculosis, prevent the development of drug-resistant strains, and reduce the risk of transmission to others. Choice A is incorrect as wearing a surgical mask at all times is not the priority teaching point for tuberculosis home care. Choice B is not the priority teaching point; while limiting visitors can help reduce exposure to others, completing the medication course is more critical. Choice D is not relevant to tuberculosis home care instructions.

5. A nurse is caring for a client who has been diagnosed with hyperkalemia. Which of the following findings should the nurse expect?

• A. Muscle weakness
• B. Nausea
• C. Increased thirst
• D. Restlessness

Correct answer: A

Rationale: Muscle weakness is a characteristic finding in hyperkalemia. High levels of potassium can affect the normal function of muscles, leading to weakness. Nausea and increased thirst are not typically associated with hyperkalemia. Restlessness is more commonly seen in conditions such as hypoxia or anxiety, not specifically in hyperkalemia.

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