Nursing Elites

1. A client in labor has an epidural for pain control. Which of the following clinical manifestations is an adverse effect of epidural anesthesia?

• A. Polyuria
• B. Hypertension
• C. Pruritus
• D. Dry mouth

Correct answer: C

Rationale: Pruritus is a common adverse effect of epidural anesthesia, often due to the opioids administered with the epidural. It presents as itching on the skin and can cause significant discomfort to the client. Polyuria (excessive urination) and dry mouth are not typical adverse effects of epidural anesthesia. Hypertension is not commonly associated with epidural anesthesia; in fact, hypotension is a more frequent complication due to sympathetic blockade. Therefore, the correct answer is pruritus (choice C), as it is a known adverse effect of epidural anesthesia.

2. A nurse is preparing to administer prochlorperazine 2.5 mg IV. Available is prochlorperazine injection 5 mg/mL. How many mL should the nurse administer?

• A. 0.2 mL
• B. 0.5 mL
• C. 1.0 mL
• D. 1.5 mL

Correct answer: B

Rationale: To determine the volume of prochlorperazine to administer, divide the prescribed dose (2.5 mg) by the concentration of the medication (5 mg/mL). This calculation results in 0.5 mL. Therefore, the nurse should administer 0.5 mL to deliver the correct dose. Choice A (0.2 mL) is incorrect as it miscalculates the dosage. Choices C (1.0 mL) and D (1.5 mL) are also incorrect as they do not accurately reflect the calculated volume needed for the dose.

3. A healthcare provider is assessing a client with congestive heart failure. Which of the following signs should the healthcare provider monitor?

• A. Peripheral edema
• B. Decreased appetite
• C. Fatigue
• D. All of the above

Correct answer: D

Rationale: Correct! In a client with congestive heart failure, peripheral edema, decreased appetite, and fatigue are important signs to monitor as they can indicate worsening heart failure. Peripheral edema is a common sign of fluid retention due to the heart's inability to pump effectively, decreased appetite may indicate worsening heart function, and fatigue can be a result of inadequate cardiac output. Monitoring all these signs is crucial for early intervention and management. Choices A, B, and C are incorrect because monitoring only one symptom may not provide a comprehensive assessment of the client's condition.

4. A nurse is reviewing the laboratory results for a client who has end-stage liver disease. Which of the following findings should the nurse expect?

• A. Elevated albumin
• B. Elevated ammonia
• C. Decreased total bilirubin
• D. Decreased prothrombin time

Correct answer: B

Rationale: In end-stage liver disease, the liver's inability to convert ammonia into urea leads to elevated ammonia levels. Elevated ammonia levels can result in hepatic encephalopathy, a serious complication. Therefore, the correct answer is B. Elevated albumin (Choice A) is not typically seen in end-stage liver disease as liver dysfunction often leads to decreased albumin levels. Decreased total bilirubin (Choice C) is unlikely in end-stage liver disease, as bilirubin levels tend to be elevated due to impaired liver function. Decreased prothrombin time (Choice D) is also not expected in end-stage liver disease, as impaired liver function results in prolonged prothrombin time.

5. A nurse is assessing a pregnant client at 32 weeks gestation and notes that the client has gained 5 pounds in one week. Which of the following conditions should the nurse suspect?

• A. Preeclampsia
• B. Gestational diabetes
• C. Anemia
• D. Placenta previa

Correct answer: A

Rationale: The correct answer is A: Preeclampsia. Rapid weight gain, especially in the third trimester, can be a sign of preeclampsia, a condition characterized by hypertension, edema, and proteinuria. This requires immediate medical attention. Choice B, Gestational diabetes, is incorrect because rapid weight gain is not a typical symptom of gestational diabetes. Choice C, Anemia, is incorrect as weight gain is not a common sign of anemia in pregnancy. Choice D, Placenta previa, is also incorrect because weight gain is not a typical symptom of this condition, which involves the placenta partially or completely covering the cervix.

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