Nursing Elites

1. A nurse is caring for a client who has osteoarthritis. Which of the following findings should the nurse expect?

• A. Joint pain that improves with rest.
• B. Joint stiffness that improves with movement.
• C. Red, warm joints.
• D. Systemic inflammation.

Correct answer: A

Rationale: In osteoarthritis, joint pain that improves with rest is a common characteristic due to the relief obtained by reducing weight-bearing on the affected joint. Joint stiffness that improves with movement is more indicative of rheumatoid arthritis, not osteoarthritis. Red, warm joints are typically seen in inflammatory arthritis conditions like rheumatoid arthritis, while systemic inflammation is not a primary feature of osteoarthritis.

2. A client with preeclampsia and postpartum hemorrhage is being cared for by a nurse. The nurse should recognize that which of the following medications is contraindicated?

• A. Methylergonovine
• B. Misoprostol
• C. Dinoprostone
• D. Oxytocin

Correct answer: A

Rationale: The correct answer is A, Methylergonovine. Methylergonovine is contraindicated in clients with preeclampsia due to the risk of hypertension. Misoprostol (choice B), Dinoprostone (choice C), and Oxytocin (choice D) are appropriate medications for managing postpartum hemorrhage and are not contraindicated in clients with preeclampsia.

3. What is the best position for a patient in respiratory distress?

• A. Semi-Fowler's position
• B. Trendelenburg position
• C. Prone position
• D. Supine position

Correct answer: A

Rationale: The best position for a patient in respiratory distress is the Semi-Fowler's position. This position promotes lung expansion and eases breathing by allowing the chest to expand more fully. The Trendelenburg position (choice B) where the patient's feet are higher than the head is not recommended in respiratory distress as it may cause increased pressure on the chest and reduced lung expansion. The prone position (choice C) lying on the stomach is also not optimal for respiratory distress as it can further compromise breathing. The supine position (choice D) lying flat on the back is not ideal as it may impair breathing by restricting chest expansion.

4. A nurse is providing education to a client who is at 28 weeks gestation and has gestational diabetes mellitus. Which of the following statements should the nurse make?

• A. You will need to increase your protein intake during pregnancy.
• B. It is important to monitor your blood glucose levels closely.
• C. Gestational diabetes can increase the risk of developing type 2 diabetes later in life.
• D. You will need to avoid exercise while managing your blood sugar.

Correct answer: C

Rationale: The correct statement the nurse should make is that gestational diabetes can increase the risk of developing type 2 diabetes later in life. This information is crucial for the client's understanding of the potential long-term implications of gestational diabetes. Monitoring blood glucose levels closely (Choice B) is also important but does not address the long-term risk of developing type 2 diabetes. Choices A and D are incorrect as increasing protein intake during pregnancy and avoiding exercise are not recommended strategies for managing gestational diabetes.

5. A client who is 2 hours postoperative following a kidney biopsy is being assessed by a nurse. Which of the following findings should the nurse report to the provider?

• A. Urinary output of 30 mL/hr.
• B. Hemoglobin 10 g/dL.
• C. Respiratory rate of 16/min.
• D. Blood pressure 110/70 mm Hg.

Correct answer: B

Rationale: The correct answer is B. A hemoglobin level of 10 g/dL is below the normal range and should be reported following a kidney biopsy to check for bleeding. Decreased hemoglobin levels could indicate internal bleeding, which is a significant concern postoperatively. Choices A, C, and D are within normal limits and do not require immediate reporting. Urinary output of 30 mL/hr is also within the acceptable range for a postoperative client. A respiratory rate of 16/min and blood pressure of 110/70 mm Hg are both normal findings postoperatively.

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