Nursing Elites

1. How should a healthcare professional manage a patient with suspected myocardial infarction (MI)?

• A. Administer oxygen and call for emergency help
• B. Monitor vital signs and provide pain relief
• C. Provide nitroglycerin and thrombolytics
• D. Administer diuretics and provide a high-protein diet

Correct answer: A

Rationale: Administering oxygen and seeking emergency help are crucial initial steps in managing a patient with suspected myocardial infarction (MI). Oxygen helps to improve oxygenation to the heart muscle, reducing its workload and preventing further damage. Calling for emergency help ensures timely access to advanced medical care, including interventions like thrombolytics. Monitoring vital signs and providing pain relief are important but secondary to the immediate need for oxygen and emergency assistance. Providing nitroglycerin and thrombolytics should be done under medical supervision and following appropriate protocols, not as the first step. Administering diuretics and altering the patient's diet are not indicated in the acute management of MI.

2. A client with type 2 diabetes mellitus is concerned about weight gain during pregnancy. Which of the following responses should the nurse make?

• A. Your weight gain should be less than that for someone without diabetes.
• B. Your weight gain should be the same as that for someone without diabetes.
• C. You should not avoid gaining weight during pregnancy.
• D. You should gain more weight to support the pregnancy.

Correct answer: B

Rationale: During pregnancy, a client with type 2 diabetes mellitus should aim for a weight gain similar to someone without diabetes to ensure a healthy pregnancy. Choice A is incorrect because weight gain should not be less; it should be adequate for pregnancy. Choice C is inaccurate as gaining some weight is essential for a healthy pregnancy. Choice D is incorrect as gaining more weight than necessary can pose risks for both the client and the baby.

3. A nurse is assisting with monitoring a client who is in labor and has spontaneous rupture of membranes following a vaginal examination. The provider reports the client's cervix is dilated to 1 cm with an unengaged presenting part. Which of the following actions should the nurse take?

• A. Encourage the client to bear down
• B. Apply the external fetal monitor
• C. Provide the client with fluids
• D. Administer IV fluids

Correct answer: B

Rationale: In this scenario, with the client's cervix dilated to only 1 cm and an unengaged presenting part, the priority action is to apply the external fetal monitor. This allows for continuous monitoring of the fetal heart rate during early labor, which is crucial for assessing fetal well-being. Encouraging the client to bear down is not appropriate at 1 cm dilation, as it may not be effective and can lead to exhaustion. Providing the client with fluids or administering IV fluids may be necessary for hydration, but the immediate concern is monitoring fetal well-being.

4. A client with peptic ulcer disease is being taught measures to prevent exacerbation of the condition. Which of the following instructions should the nurse include?

• A. Avoid consuming dairy products
• B. Limit alcohol consumption
• C. Use antacids frequently
• D. Drink coffee to improve digestion

Correct answer: B

Rationale: The correct answer is B: Limit alcohol consumption. Alcohol can irritate the stomach lining and worsen peptic ulcer disease. Avoiding dairy products is not necessary unless the client is lactose intolerant. Using antacids frequently may provide symptomatic relief but does not address the root cause of the condition. Drinking coffee can actually stimulate acid production and potentially aggravate peptic ulcers.

5. What is the correct way to assess for pitting edema?

• A. Press over the bony area for 5 seconds and release
• B. Press over the skin for 10 seconds and check for discoloration
• C. Press the area and check for the presence of rash
• D. Press the skin and assess for rebound tenderness

Correct answer: A

Rationale: The correct way to assess for pitting edema is to press over a bony area, typically the tibia, for 5 seconds and then release. This allows for the identification of pitting edema, characterized by an indentation that persists for a few seconds. Choice B is incorrect as pitting edema assessment does not involve checking for discoloration. Choice C is incorrect as the presence of a rash is not indicative of pitting edema. Choice D is incorrect as rebound tenderness is a different assessment used for abdominal conditions, not for pitting edema.

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