Nursing Elites

1. A healthcare provider is assessing a client with chronic obstructive pulmonary disease (COPD) receiving oxygen therapy. Which of the following findings indicates oxygen toxicity?

• A. Oxygen saturation 94%
• B. Decreased respiratory rate
• C. Wheezing
• D. Peripheral cyanosis

Correct answer: B

Rationale: The correct answer is B: Decreased respiratory rate. In clients with COPD, especially when receiving oxygen therapy, a decreased respiratory rate is indicative of oxygen toxicity. This occurs because their respiratory drive is often dependent on low oxygen levels. Oxygen saturation of 94% is within an acceptable range and does not necessarily indicate oxygen toxicity. Wheezing is more commonly associated with airway narrowing or constriction, while peripheral cyanosis is a sign of decreased oxygen levels in the peripheral tissues, not oxygen toxicity.

2. A nurse is caring for a client who is experiencing preterm labor and has a new prescription for terbutaline. Which of the following findings is a contraindication for the administration of this medication?

• A. Heart disease
• B. Cervical dilation of 2 cm
• C. Gestational age of 34 weeks
• D. Allergy to penicillin

Correct answer: A

Rationale: The correct answer is A, heart disease. Terbutaline is contraindicated in clients with heart disease because it can lead to tachycardia and other cardiac complications due to its beta-agonist properties. Choice B, cervical dilation of 2 cm, is not a contraindication for terbutaline administration in preterm labor. Choice C, gestational age of 34 weeks, does not contraindicate the use of terbutaline for preterm labor. Choice D, allergy to penicillin, is not related to the contraindications of terbutaline.

3. A nurse is caring for a client who is receiving oxytocin IV for augmentation of labor. The client’s contractions are occurring every 45 seconds with a duration of 90 seconds, and the fetal heart rate is 170-180/minute. Which of the following actions should the nurse take?

• A. Discontinue the oxytocin infusion
• B. Increase the oxytocin infusion
• C. Decrease the oxytocin infusion
• D. Maintain the oxytocin infusion

Correct answer: A

Rationale: In this scenario, the contractions are too frequent (tachysystole), and the fetal heart rate is elevated. Tachysystole can lead to decreased oxygen perfusion to the fetus, causing fetal distress. Therefore, the correct action for the nurse to take is to discontinue the oxytocin infusion to prevent harm to both the mother and fetus. Increasing or maintaining the oxytocin infusion would exacerbate the current situation, potentially leading to further complications. Decreasing the oxytocin infusion may not be sufficient to address the tachysystole and elevated fetal heart rate, making it an inappropriate choice.

4. When educating a patient on the use of levodopa-carbidopa, which information should the nurse include?

• A. It is a cure for Parkinson's disease
• B. Monitor for dyskinesia
• C. It can be taken at any time
• D. It has no side effects

Correct answer: B

Rationale: The correct answer is B: 'Monitor for dyskinesia.' Levodopa-carbidopa can cause dyskinesia as a side effect, which is characterized by involuntary muscle movements. Patients need to be monitored for this adverse effect and instructed to report it to their healthcare provider. Choices A, C, and D are incorrect because levodopa-carbidopa is not a cure for Parkinson's disease, it should be taken at specific times for optimal effect, and it does have side effects, such as dyskinesia.

5. A nurse is planning care for a client with a sealed radiation implant. Which intervention should the nurse implement?

• A. Remove dirty linens after double-bagging them
• B. Wear a dosimeter badge in the client’s room
• C. Limit visitors to 1 hour per day
• D. Ensure family remains 3 feet away from the client

Correct answer: B

Rationale: The nurse should wear a dosimeter badge to monitor radiation exposure when caring for a client with a sealed radiation implant.

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