Nursing Elites

1. A nurse is caring for a client who has an altered mental status and has become aggressive. Which of the following prescriptions should the nurse clarify with the provider prior to administration?

• A. Haloperidol
• B. Zolpidem
• C. Morphine
• D. Lorazepam

Correct answer: B

Rationale: The correct answer is B: Zolpidem. Zolpidem is a sedative-hypnotic medication that can worsen altered mental status, especially in clients who are already aggressive. Therefore, the nurse should clarify this prescription with the provider before administration to ensure it is safe for the client. Choice A, Haloperidol, is an antipsychotic commonly used to manage aggression in clients with altered mental status, making it an appropriate choice in this scenario. Choice C, Morphine, is an opioid analgesic and would not directly impact the client's altered mental status or aggression. Choice D, Lorazepam, is a benzodiazepine used to manage anxiety and agitation, which could be beneficial in this situation but does not have the same potential to exacerbate altered mental status as Zolpidem.

2. What is the study of conduct and character?

• A. Ethics
• B. Justice
• C. Morals
• D. Non-maleficence

Correct answer: A

Rationale: Ethics is the correct answer because it specifically deals with the study of conduct and character. Ethics is a branch of philosophy that involves systematizing, defending, and recommending concepts of right and wrong conduct. While justice and morals are related to ethical considerations, they do not directly represent the study of conduct and character. Non-maleficence is a principle in medical ethics related to avoiding harm.

3. A 23-year-old woman at 32-weeks gestation is seen in the outpatient clinic. Which of the following findings, if assessed by the nurse, would indicate a possible complication?

• A. The client's urine test is positive for glucose and acetone
• B. The client has 1+ pedal edema in both feet at the end of the day
• C. The client complains of an increase in vaginal discharge
• D. The client says she feels pressure against her diaphragm when the baby moves

Correct answer: A

Rationale: The correct answer is A. Positive urine glucose and acetone could indicate gestational diabetes or preeclampsia, both of which are complications. Choice B, pedal edema, is common in pregnancy but may also be a sign of preeclampsia if severe. Choice C, an increase in vaginal discharge, is a normal finding in pregnancy due to hormonal changes. Choice D, pressure against the diaphragm when the baby moves, is a normal sensation due to the growing uterus displacing abdominal contents.

4. A healthcare provider is reviewing the medical record of a client who has hypertension. Which of the following findings should the provider identify as a risk factor for this condition?

• A. Age 25 years
• B. Family history of hypotension
• C. Obesity
• D. History of hypotension

Correct answer: C

Rationale: The correct answer is C: Obesity. Obesity is a significant risk factor for hypertension due to its impact on the cardiovascular system. Obesity can lead to increased blood pressure due to the additional workload placed on the heart and blood vessels. Age alone does not necessarily predispose someone to hypertension, and a family history of hypotension or a personal history of hypotension would not increase the risk of developing hypertension. Family history of hypotension is not a known risk factor for hypertension, and a history of hypotension actually indicates low blood pressure, which is the opposite of hypertension.

5. 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.

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