Nursing Elites

1. A nurse is caring for a client who is in labor and is receiving electronic fetal monitoring. The nurse notes early decelerations. Which of the following should the nurse expect?

• A. Fetal hypoxia
• B. Head compression
• C. Placenta previa
• D. Umbilical cord prolapse

Correct answer: B

Rationale: In the scenario of early decelerations noted during labor with electronic fetal monitoring, the nurse should expect head compression. Early decelerations are a normal response to fetal head compression during contractions and are not indicative of fetal distress. Choice A, fetal hypoxia, is incorrect as early decelerations are not associated with fetal oxygen deprivation. Choices C and D, placenta previa and umbilical cord prolapse, are unrelated to the scenario described and do not cause early decelerations.

2. A healthcare professional is preparing education material for a client. Which of the following techniques should the professional use in creating material?

• A. Emphasize important information using bold lettering.
• B. Use a 7th-grade reading level.
• C. Avoid using cartoons in the material.
• D. Use words with three or four syllables.

Correct answer: B

Rationale: The correct answer is to 'Use a 7th-grade reading level.' This ensures that the material is accessible to most clients by keeping the language simple and easy to understand. Emphasizing important information using bold lettering (Choice A) can be helpful but may not enhance overall readability. Avoiding cartoons (Choice C) is not a universal rule and can sometimes make the material more engaging. Using words with three or four syllables (Choice D) can make the material difficult to comprehend for many clients.

3. A nurse is caring for a client who is receiving continuous cardiac monitoring. The client's heart rate is 69/min, and the PR interval is 0.24 seconds. What cardiac rhythm should the nurse interpret this finding as?

• A. First-degree AV block.
• B. Premature ventricular contraction.
• C. Sinus bradycardia.
• D. Atrial fibrillation.

Correct answer: A

Rationale: The correct answer is A: First-degree AV block. A PR interval of 0.24 seconds indicates a prolonged PR interval, which is characteristic of first-degree AV block. This rhythm is considered benign and often does not require treatment. Choice B, premature ventricular contraction, is characterized by early, abnormal ventricular contractions and would not be indicated by the findings provided. Choice C, sinus bradycardia, would present with a normal PR interval but a heart rate less than 60 beats per minute. Choice D, atrial fibrillation, is characterized by an irregularly irregular rhythm with no identifiable P waves, which does not align with the findings of a prolonged PR interval in this scenario.

4. A client has a new prescription for nitroglycerin sublingual tablets. Which of the following instructions should the nurse include?

• A. Take the medication with a full glass of water.
• B. Take the medication with food to prevent stomach upset.
• C. Take one tablet every 5 minutes, up to three doses, for chest pain.
• D. Swallow the tablet whole for the best effect.

Correct answer: C

Rationale: The correct instruction for a client with a new prescription for nitroglycerin sublingual tablets is to take one tablet every 5 minutes, up to three doses, for chest pain. This dosing regimen helps relieve chest pain associated with angina by promoting vasodilation. Option A is incorrect as nitroglycerin sublingual tablets should be placed under the tongue, not swallowed with water. Option B is incorrect because taking nitroglycerin with food may decrease its effectiveness. Option D is incorrect because nitroglycerin sublingual tablets are meant to be dissolved under the tongue, not swallowed whole.

5. A client has a new prescription for levothyroxine. Which of the following statements should the nurse include?

• A. Take this medication with food to prevent nausea.
• B. Take this medication in the morning to prevent insomnia.
• C. You should store this medication in the refrigerator.
• D. Take this medication with a full glass of water before breakfast.

Correct answer: D

Rationale: The correct statement the nurse should include is to take levothyroxine with a full glass of water before breakfast. This helps improve absorption and prevents gastrointestinal side effects. Choice A is incorrect because levothyroxine should be taken on an empty stomach. Choice B is incorrect as insomnia is not a common side effect of levothyroxine. Choice C is also incorrect as levothyroxine does not need to be refrigerated.

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