Nursing Elites

1. A 31-year-old client is seeking contraceptive information. Before responding to the client’s questions about contraceptives, the nurse obtains a health history. What factor in the client’s history indicates to the nurse that oral contraceptives are contraindicated?

• A. More than 30 years of age
• B. Had two multiple pregnancies
• C. Smokes 1 pack of cigarettes a day
• D. Has a history of borderline hypertension

Correct answer: C

Rationale: The correct answer is C. Smoking, especially in clients over 30, increases the risk of thromboembolic events, making oral contraceptives contraindicated. Choice A (More than 30 years of age) is not a direct contraindication for oral contraceptives. Choice B (Had two multiple pregnancies) is not a factor that contraindicates the use of oral contraceptives. Choice D (Has a history of borderline hypertension) is not a specific contraindication for oral contraceptives unless it is severe or uncontrolled hypertension.

2. The nurse is caring for a client diagnosed with rule-out nephritic syndrome. Which intervention should be included in the plan of care?

• A. Monitor the urine for bright-red bleeding
• B. Evaluate the calorie count of the 500-mg protein diet
• C. Assess the client’s sacrum for dependent edema
• D. Monitor for a high serum albumin level

Correct answer: C

Rationale: The correct intervention to include in the plan of care for a client with rule-out nephritic syndrome is to assess the client’s sacrum for dependent edema. Dependent edema is common in nephritic syndrome due to protein loss, and monitoring for this helps manage the condition. Choices A, B, and D are incorrect. Monitoring the urine for bright-red bleeding may be more relevant for a client with a different condition, such as glomerulonephritis. Evaluating the calorie count of a 500-mg protein diet is not directly related to managing nephritic syndrome. Monitoring for a high serum albumin level does not directly address the symptom of dependent edema associated with nephritic syndrome.

3. The nurse on the postsurgical unit received a client that was transferred from the post-anesthesia care unit (PACU) and is planning care for this client. The nurse understands that staff should begin planning for this client’s discharge at which point during the hospitalization?

• A. Is admitted to the surgical unit
• B. Is transferred from the PACU to the postsurgical unit
• C. Is able to perform activities of daily living independently
• D. Has been assessed by the healthcare provider for the first time after surgery

Correct answer: A

Rationale: Discharge planning should begin as soon as the patient is admitted to the surgical unit to ensure a smooth transition. Option A is the correct choice because it marks the initial point in the hospitalization process where discharge planning should start. Options B, C, and D are not the ideal points to begin discharge planning. Option B only signifies a transfer within the hospital, while Option C relates to the patient's independence in activities of daily living, which is not directly linked to discharge planning. Option D, having the patient assessed by the healthcare provider for the first time after surgery, is unrelated to the timing of discharge planning.

4. Which of the following drugs contribute to peptic ulcers?

• A. Antacids
• B. Certain antibiotics
• C. Cholesterol-lowering medications
• D. Nonsteroidal anti-inflammatory drugs

Correct answer: D

Rationale: The correct answer is D: Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs are known to contribute to peptic ulcers by affecting the gastric mucosa. Choice A, Antacids, actually help to alleviate symptoms of peptic ulcers by neutralizing stomach acid. Choice B, Certain antibiotics, are used to treat H. pylori infections, a common cause of peptic ulcers. Choice C, Cholesterol-lowering medications, do not contribute to peptic ulcers.

5. What instructions should the nurse discuss with the client diagnosed with Raynaud’s phenomenon?

• A. Explain that exacerbations will not occur in the summer
• B. Use nicotine gum to help quit smoking
• C. Wear extra warm clothing during cold exposure
• D. Avoid prolonged exposure to direct sunlight

Correct answer: C

Rationale: The correct answer is to wear extra warm clothing during cold exposure. This instruction is crucial for managing Raynaud’s phenomenon as it helps prevent vasospasms triggered by cold temperatures. Choice A is incorrect because exacerbations can occur in any season. Choice B is not directly related to managing Raynaud’s phenomenon. Choice D is also irrelevant as direct sunlight exposure does not typically worsen symptoms of Raynaud’s phenomenon.

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