Nursing Elites

1. A client is recovering from an acute myocardial infarction. Which of the following interventions should the nurse include in the plan of care?

• A. Draw a troponin level every four hours
• B. Perform an EKG every 12 hours
• C. Plan for oxygen therapy with a rebreather mask
• D. Obtain a cardiac rehabilitation consult

Correct answer: D

Rationale: The correct answer is to obtain a cardiac rehabilitation consult. Cardiac rehabilitation is an essential part of the care plan for a client recovering from a myocardial infarction. It helps in improving recovery, enhancing quality of life, and reducing the risk of future cardiac events. Drawing troponin levels and performing EKGs are important for diagnosing and monitoring myocardial infarctions but are not interventions in the post-MI care plan. Oxygen therapy may be necessary based on the client's condition but is not specific to post-MI care.

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 client has a new prescription for metformin. Which of the following should the nurse educate the client about?

• A. It can cause weight gain
• B. It should be taken with meals
• C. It is an injectable medication
• D. It can cause hypoglycemia

Correct answer: B

Rationale: The correct answer is B: 'It should be taken with meals.' Metformin should be taken with meals to minimize gastrointestinal side effects and improve absorption. Choice A is incorrect because metformin is actually associated with weight loss or weight neutrality. Choice C is incorrect as metformin is typically taken orally and not via injection. Choice D is also incorrect because metformin is not known to cause hypoglycemia as a primary side effect.

4. A nurse is caring for a client in preterm labor who is receiving magnesium sulfate by continuous IV infusion. Which of the following client findings indicates medication toxicity?

• A. Blood glucose of 150 mg/dL
• B. Urine output of 20 mL per hour
• C. Systolic blood pressure of 140 mm Hg
• D. BUN 20 mg/dL

Correct answer: B

Rationale: A urine output of 20 mL per hour is low and indicates renal insufficiency, a sign of magnesium sulfate toxicity. The medication is excreted by the kidneys, so toxicity can occur if renal function declines. Blood glucose of 150 mg/dL is within normal range and not indicative of magnesium sulfate toxicity. A systolic blood pressure of 140 mm Hg is elevated but not specifically related to magnesium sulfate toxicity. A BUN level of 20 mg/dL is also within normal limits and not a sign of medication toxicity.

5. A nurse is teaching a group of clients about the risk factors for osteoporosis. Which of the following should the nurse include as a risk factor for osteoporosis?

• A. Early menopause
• B. History of falls
• C. African American race
• D. Obesity

Correct answer: A

Rationale: The correct answer is A: Early menopause. A client who goes into early menopause, from natural or surgical causes, is at greater risk for developing osteoporosis due to the rapid drop in estrogen levels. Choice B, history of falls, is not a direct risk factor for osteoporosis but can lead to fractures in individuals with osteoporosis. Choice C, African American race, is actually associated with a lower risk of osteoporosis compared to Caucasian or Asian descent. Choice D, obesity, is generally considered a protective factor against osteoporosis due to the increased mechanical loading on bones.

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