Nursing Elites

1. A client who is postpartum requests information about contraception. Which of the following instructions should the nurse include?

• A. The lactation amenorrhea method is effective for the first year postpartum.
• B. You should not use the diaphragm used before your pregnancy.
• C. Apply the transdermal birth control patch on your upper arm.
• D. Avoid using vaginal spermicides while breastfeeding.

Correct answer: D

Rationale: The correct answer is to advise the client to avoid using vaginal spermicides while breastfeeding. This instruction is important as spermicides can potentially affect the milk supply and cause irritation. Choice A is incorrect because the effectiveness of the lactation amenorrhea method diminishes after the first six months postpartum. Choice B is incorrect as using the diaphragm used before pregnancy may not fit properly due to changes in the body postpartum. Choice C is incorrect as the transdermal birth control patch is typically applied to the abdomen, buttocks, or upper torso, not specifically the upper arm.

2. A client with heart failure is receiving furosemide. Which of the following findings should the nurse report to the provider?

• A. Heart rate of 80/min.
• B. Weight loss of 1.1 kg (2.5 lb) in 24 hours.
• C. Potassium level of 3.8 mEq/L.
• D. Urine output of 60 mL/hr.

Correct answer: B

Rationale: A weight loss of 1.1 kg (2.5 lb) in 24 hours may indicate dehydration or fluid imbalance, which should be reported. This rapid weight loss could be a sign of excessive diuresis, potentially leading to hypovolemia or electrolyte imbalances. Monitoring weight changes is crucial in clients with heart failure receiving diuretics. The other findings are within normal ranges and expected in a client receiving furosemide for heart failure. A heart rate of 80/min, a potassium level of 3.8 mEq/L, and a urine output of 60 mL/hr are generally acceptable in this scenario.

3. When preparing education materials for a client, what technique should be used to make the information accessible?

• 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 technique ensures that the information provided is accessible and easily understandable for most clients. Using simple language helps to avoid confusion and ensures that the message is conveyed clearly. Emphasizing important information using bold lettering (Choice A) can be helpful but may not improve overall accessibility. Avoiding cartoons in the material (Choice C) is not directly related to making information accessible. Using words with three or four syllables (Choice D) can complicate the material and hinder understanding, making it less accessible.

4. A nurse is caring for a client who has chronic obstructive pulmonary disease (COPD). Which of the following findings should the nurse report to the provider?

• A. Oxygen saturation of 92%
• B. Use of pursed-lip breathing
• C. Increased anterior-posterior chest diameter
• D. Productive cough with green sputum

Correct answer: D

Rationale: The correct answer is D. A productive cough with green sputum can indicate a bacterial infection, which is a concern for clients with COPD. Reporting this finding to the provider is important for further evaluation and management. Choices A, B, and C are not as concerning in the context of COPD management. An oxygen saturation of 92% is within an acceptable range for COPD patients, pursed-lip breathing is a helpful technique for managing breathing difficulties in COPD, and an increased anterior-posterior chest diameter is a common finding in clients with COPD due to chronic air trapping.

5. A healthcare provider is assessing a newborn who has a patent ductus arteriosus. Which of the following findings should the provider expect?

• A. Continuous murmur.
• B. Absent peripheral pulses.
• C. Increased blood pressure.
• D. Bounding pulses.

Correct answer: A

Rationale: A continuous murmur is a classic finding in a newborn with patent ductus arteriosus. This murmur is typically heard between the first and second heart sounds and throughout systole. Absent peripheral pulses (choice B) are not typically associated with patent ductus arteriosus. Increased blood pressure (choice C) and bounding pulses (choice D) are not commonly seen with this condition. Therefore, the correct answer is A.

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