Nursing Elites

1. A nurse is caring for a client who has severe preeclampsia and is receiving magnesium sulfate. The nurse should monitor the client for which of the following findings as an indication of magnesium toxicity?

• A. Decreased deep tendon reflexes
• B. Elevated blood pressure
• C. Increased urinary output
• D. Hyperreflexia

Correct answer: A

Rationale: The correct answer is A: Decreased deep tendon reflexes. Magnesium sulfate toxicity can lead to diminished deep tendon reflexes, respiratory depression, and decreased urine output. Diminished deep tendon reflexes are an early sign of magnesium toxicity and indicate the need to discontinue the infusion. Elevated blood pressure (choice B) is not typically associated with magnesium toxicity. Increased urinary output (choice C) is also not a common finding in magnesium toxicity. Hyperreflexia (choice D) is not consistent with the expected findings of magnesium toxicity, which typically causes decreased reflexes.

2. A nurse is reviewing the medication class, benzodiazepines. The nurse would use caution when administering benzodiazepines to which of the clients below?

• A. A client with glaucoma
• B. A client with renal failure
• C. A client with hypertension
• D. A client with insomnia

Correct answer: A

Rationale: Benzodiazepines can increase intraocular pressure, which is why they must be used cautiously in patients with glaucoma. In clients with this condition, benzodiazepines can potentially worsen symptoms and lead to further complications involving the eyes. Therefore, administering benzodiazepines to a client with glaucoma should be done with caution. Choices B, C, and D are not directly contraindicated with benzodiazepines, making them less likely to cause harm compared to administering to a client with glaucoma.

3. A client is experiencing urinary incontinence, and a nurse is providing care. Which of the following recommendations should the nurse include in the teaching plan for this client?

• A. Drink large amounts of water before bedtime
• B. Perform Kegel exercises regularly
• C. Limit fiber intake in the diet to avoid bowel irritation
• D. Increase intake of caffeinated and carbonated beverages

Correct answer: B

Rationale: The correct recommendation for a client experiencing urinary incontinence is to perform Kegel exercises regularly. These exercises help strengthen the pelvic floor muscles, improving bladder control and reducing urinary incontinence. Option A is incorrect because drinking large amounts of water before bedtime can worsen urinary incontinence by increasing urine production. Option C is incorrect as fiber is important for bowel health and limiting it may not be beneficial for the client. Option D is incorrect as caffeinated and carbonated beverages can irritate the bladder and worsen urinary incontinence, so they should be avoided.

4. A healthcare professional is preparing to administer ceftriaxone. Which of the following actions should the healthcare professional take?

• A. Reconstitute the medication with normal saline
• B. Reconstitute the medication with sterile water
• C. Administer the medication over 30 minutes
• D. Monitor for signs of toxicity

Correct answer: B

Rationale: Correct Answer: B. Ceftriaxone should be reconstituted with sterile water, not saline. Reconstituting it with normal saline can result in a chemical interaction and precipitation of the drug. Administering the medication over 30 minutes (choice C) is not necessary as ceftriaxone is usually given as an intravenous bolus or drip over a shorter period. Monitoring for signs of toxicity (choice D) is important but not the immediate action required for preparing the medication. The priority is to ensure proper reconstitution with the appropriate solvent, which is sterile water.

5. A nurse is completing a dietary assessment for a client who observes kosher dietary practices. Which of the following behaviors should the nurse expect?

• A. Leavened bread may be eaten during Passover
• B. Shellfish is commonly consumed in the diet
• C. Meat and dairy products are eaten separately
• D. Fasting from meat occurs during Hanukkah

Correct answer: C

Rationale: The correct answer is C: 'Meat and dairy products are eaten separately.' In kosher dietary practices, it is essential to keep meat and dairy products separate. Mixing meat and dairy is prohibited, and there are specific guidelines for the preparation and consumption of each. Choices A, B, and D are incorrect. Choice A is wrong because leavened bread is not eaten during Passover in kosher practices. Choice B is incorrect as shellfish is not consumed in a kosher diet. Choice D is also inaccurate as fasting from meat does not occur during Hanukkah in kosher dietary practices.

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