Nursing Elites

1. A nurse is caring for a client in active labor. The nurse notes variable decelerations in the fetal heart rate. Which of the following is the priority nursing action?

• A. Administer oxygen
• B. Reposition the client
• C. Prepare for delivery
• D. Increase IV fluids

Correct answer: B

Rationale: The correct answer is to reposition the client. Variable decelerations are often caused by umbilical cord compression. Repositioning the client can help alleviate pressure on the cord and improve fetal oxygenation. Administering oxygen may be necessary in some situations, but repositioning the client takes precedence to address the underlying cause of variable decelerations. While preparing for delivery is important, addressing the immediate concern of variable decelerations by repositioning the client is the priority. Increasing IV fluids is not the priority in this situation as it does not directly address the cause of variable decelerations.

2. A nurse is caring for a client who has acute pancreatitis. Which of the following laboratory findings should the nurse expect?

• A. Decreased serum amylase
• B. Decreased serum lipase
• C. Elevated blood glucose
• D. Elevated calcium levels

Correct answer: C

Rationale: In acute pancreatitis, the nurse should expect elevated blood glucose levels. This is due to impaired insulin production by the inflamed pancreas. While serum amylase and lipase levels are typically elevated in acute pancreatitis, blood glucose levels are also affected due to the pancreatic dysfunction. Therefore, choices A and B are incorrect. Elevated calcium levels are not typically associated with acute pancreatitis, making choice D incorrect.

3. When educating a patient about gabapentin use, what should the nurse include?

• A. It can cause sedation
• B. It can be taken with alcohol
• C. It is a pain reliever
• D. It has no side effects

Correct answer: A

Rationale: The correct answer is A: 'It can cause sedation.' Gabapentin is known to cause sedation, and patients should be advised about this side effect, especially regarding activities that require alertness. Choice B is incorrect because gabapentin should not be taken with alcohol as it can increase the risk of central nervous system depression. Choice C is incorrect because while gabapentin is used to treat nerve pain, it is not classified as a traditional pain reliever. Choice D is incorrect because gabapentin, like any medication, can have side effects, such as dizziness, drowsiness, and fatigue.

4. A nurse is reviewing the guidelines for reporting nationally notifiable infectious diseases. What disease should the nurse report to the CDC?

• A. Measles
• B. Hepatitis A
• C. Lyme disease
• D. Zika

Correct answer: C

Rationale: The correct answer is Lyme disease. Lyme disease must be reported to the CDC as it is a nationally notifiable infectious disease. It is spread by ticks and can lead to significant health issues if not monitored. Measles, Hepatitis A, and Zika are also important infectious diseases, but in this case, Lyme disease is the appropriate choice based on the information provided.

5. A nurse is providing discharge teaching to a client who is starting to take carbidopa/levodopa to treat Parkinson’s disease. Which of the following instructions should the nurse include in the teaching?

• A. “This medication can cause your urine to turn a dark color.”
• B. “Expect immediate relief after taking this medication.”
• C. “Take the medication with a high-protein food.”
• D. “Skip a dose of the medication if you experience dizziness.”

Correct answer: A

Rationale: The correct instruction the nurse should provide is that the medication can cause the client's urine to turn a dark color, which is a harmless effect of carbidopa/levodopa. This is due to the metabolites of levodopa. Immediate relief is not expected after taking the medication because it may take weeks to months to achieve the full therapeutic effect. Taking the medication with a high-protein food is not recommended as protein can interfere with the absorption of levodopa. Skipping a dose of the medication if the client experiences dizziness is incorrect as dizziness may be a side effect of the medication, and doses should not be skipped without consulting a healthcare provider.

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