Nursing Elites

1. 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.

2. A nurse is providing teaching to family members of a client who has dementia. Which of the following instructions should the nurse include?

• A. Establish a toileting schedule for the client.
• B. Use clothing with buttons and zippers.
• C. Discourage physical activity during the day.
• D. Engage the client in activities that increase sensory stimulation.

Correct answer: A

Rationale: The correct answer is A: Establish a toileting schedule for the client. A toileting schedule helps manage incontinence and prevent accidents, promoting client dignity. Choice B is incorrect because clothing with buttons and zippers may be difficult for a client with dementia to manage independently. Choice C is incorrect as physical activity during the day is beneficial for clients with dementia. Choice D is incorrect as activities that increase sensory stimulation may be overwhelming for a client with dementia.

3. A nurse is preparing to apply a transdermal nicotine patch for a client. Which of the following actions should the nurse take?

• A. Shave hairy areas of skin prior to application.
• B. Wear gloves to apply the patch to the client's skin.
• C. Apply the patch within 1 hr of removing it from the protective pouch.
• D. Remove the previous patch and place it in a tissue.

Correct answer: B

Rationale: The correct answer is to wear gloves to apply the patch to the client's skin. This action ensures that the nurse does not absorb any medication through their own skin, promoting safety. Choice A is incorrect because shaving is not necessary and could irritate the skin. Choice C is incorrect because transdermal patches should be applied immediately after removal from the protective pouch to maintain their efficacy. Choice D is incorrect because used patches should be folded and discarded safely according to facility protocols.

4. A nurse is preparing to insert an IV catheter for a client. Which of the following actions should the nurse take?

• A. Apply a tourniquet above the insertion site
• B. Shave the area around the insertion site
• C. Insert the catheter at a 15-degree angle
• D. Use an 18-gauge needle for insertion

Correct answer: C

Rationale: The correct answer is to insert the catheter at a 15-degree angle. This angle allows for easier venous access by ensuring proper catheter placement into the vein. Applying a tourniquet above the insertion site can help distend the vein for better visualization but is not the immediate action required for the insertion process. Shaving the area around the insertion site is not necessary unless there is excessive hair that may interfere with the insertion. Using an 18-gauge needle for insertion is a specific detail related to the equipment rather than the technique of insertion.

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

• A. Hemoglobin
• B. Bilirubin
• C. Amylase
• D. Creatinine

Correct answer: C

Rationale: The correct answer is C: Amylase. Amylase levels are elevated in clients with acute pancreatitis due to inflammation of the pancreas. Elevated hemoglobin (choice A) is not typically associated with acute pancreatitis. Bilirubin (choice B) may be elevated in conditions affecting the liver, not specifically in acute pancreatitis. Creatinine (choice D) is a marker of kidney function and is not directly related to acute pancreatitis.

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