Nursing Elites

1. A nurse is caring for a client who is at 14 weeks of gestation and has hyperemesis gravidarum. Which of the following medications should the nurse plan to administer?

• A. Digoxin
• B. Calcium gluconate
• C. Vitamin B6
• D. Propranolol

Correct answer: C

Rationale: The correct answer is C: Vitamin B6 (pyridoxine). Vitamin B6 is often used to treat nausea and vomiting in pregnancy, including hyperemesis gravidarum. It is considered safe for use in pregnant clients. Digoxin (Choice A) is a medication used for heart conditions, not for hyperemesis gravidarum. Calcium gluconate (Choice B) is used to treat calcium deficiencies, not nausea and vomiting in pregnancy. Propranolol (Choice D) is a beta-blocker used for conditions like hypertension and anxiety, not for hyperemesis gravidarum.

2. During a skin assessment on a client with risk factors for skin cancer, a nurse should understand that a suspicious lesion is:

• A. Scaly and red
• B. Asymmetric with variegated coloring
• C. Firm and rubbery
• D. Brown with a wart-like texture

Correct answer: B

Rationale: The correct answer is B: Asymmetric with variegated coloring. An asymmetric lesion with variegated coloring, meaning different shades of color within the same lesion, is characteristic of melanoma, a type of skin cancer. This type of lesion should raise suspicions and prompt further evaluation. Choices A, C, and D do not typically represent characteristics of suspicious skin lesions associated with skin cancer. Lesions that are scaly and red (Choice A) may indicate other skin conditions like eczema or psoriasis. Firm and rubbery lesions (Choice C) are more suggestive of benign skin growths like dermatofibromas. Lesions that are brown with a wart-like texture (Choice D) are often indicative of seborrheic keratosis, a benign growth, rather than a suspicious lesion related to skin cancer.

3. A client with chronic kidney disease is about to start hemodialysis. Which of the following instructions should the nurse include?

• A. Increase protein intake between dialysis sessions
• B. Reduce potassium intake
• C. Avoid iron supplements
• D. Expect weight gain after each dialysis session

Correct answer: B

Rationale: The correct answer is to instruct the client to reduce potassium intake. Clients with chronic kidney disease should limit potassium intake to prevent hyperkalemia, as the kidneys may struggle to remove excess potassium. Increasing protein intake between dialysis sessions (Choice A) is not recommended as it can increase urea production, adding to the workload of the kidneys. Avoiding iron supplements (Choice C) is not necessary unless iron levels are high. Expecting weight gain after each dialysis session (Choice D) is incorrect as patients typically experience weight loss due to fluid removal during dialysis.

4. A client is being taught about the use of digoxin. Which of the following should be included?

• A. Monitor for low blood pressure
• B. It can cause bradycardia
• C. Take it with calcium supplements
• D. It has no side effects

Correct answer: B

Rationale: The correct answer is B: 'It can cause bradycardia.' Digoxin can cause bradycardia as one of its side effects. Clients should be educated about this potential effect and instructed to monitor their heart rate before taking the medication. Choice A is incorrect because digoxin is more likely to cause arrhythmias than low blood pressure. Choice C is incorrect as calcium supplements can interfere with the absorption of digoxin. Choice D is incorrect as digoxin has various side effects, and clients should be aware of them.

5. A postpartum complication a client is at risk for is deep-vein thrombosis. Which of the following factors is strongly associated with this postpartum complication?

• A. Cesarean birth
• B. Vaginal birth
• C. Anemia
• D. Multiparity

Correct answer: A

Rationale: The correct answer is A: Cesarean birth. Cesarean birth doubles the risk for deep-vein thrombosis (DVT) due to immobility and vascular changes associated with surgery. Other risk factors for DVT include smoking, obesity, and a history of thromboembolism. Vaginal birth, anemia, and multiparity are not strongly associated with an increased risk of deep-vein thrombosis postpartum. It is important to educate clients undergoing cesarean birth about the increased risk of DVT and measures to prevent it, such as early ambulation and the use of compression stockings.

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