Nursing Elites

1. A client has been prescribed metformin. What should be included in the teaching?

• A. It can cause weight gain
• B. Take it with food
• C. It is an insulin
• D. Monitor for hyperglycemia

Correct answer: B

Rationale: The correct answer is to take metformin with food. This is important to minimize gastrointestinal side effects and improve absorption. Choice A is incorrect as metformin is not typically associated with weight gain. Choice C is wrong as metformin is not an insulin but a medication that helps control blood sugar levels. Choice D is also incorrect as metformin is not known to cause hyperglycemia.

2. A healthcare provider is caring for a client with severe preeclampsia. Which of the following medications should the healthcare provider anticipate administering?

• A. Magnesium sulfate
• B. Oxytocin
• C. Misoprostol
• D. Nifedipine

Correct answer: A

Rationale: Magnesium sulfate is the correct answer as it is administered to prevent seizures in clients with severe preeclampsia. It acts as a central nervous system depressant and is the first-line treatment for eclampsia prevention. Oxytocin (Choice B) is used to induce or augment labor, not indicated specifically for preeclampsia. Misoprostol (Choice C) is used for labor induction and postpartum hemorrhage, not typically indicated for preeclampsia. Nifedipine (Choice D) is a calcium channel blocker used for managing hypertension in pregnancy but is not the first-line treatment for preventing seizures in severe preeclampsia.

3. A nurse is caring for a client who is at 38 weeks of gestation and is experiencing continuous abdominal pain and vaginal bleeding. The client has a history of cocaine use. The nurse should identify that the client is likely experiencing which of the following complications?

• A. Abruptio placentae
• B. Hydatidiform mole
• C. Preterm labor
• D. Placenta previa

Correct answer: A

Rationale: Continuous abdominal pain and vaginal bleeding in a client with a history of cocaine use suggest abruptio placentae, where the placenta detaches from the uterus prematurely, posing serious risks to both mother and fetus. Hydatidiform mole is characterized by abnormal trophoblastic tissue growth, not continuous pain and bleeding. Preterm labor is premature contractions leading to birth before 37 weeks gestation. Placenta previa involves the placenta partially or completely covering the cervix, presenting with painless vaginal bleeding.

4. A nurse is providing teaching to a client about the Papanicolaou (Pap) test. Which of the following information should the nurse include in the teaching?

• A. A Pap test is recommended every 3 years for women aged 21-29 and every 3-5 years for women aged 30-65.
• B. Pap tests are recommended following removal of the ovaries.
• C. Avoid having sexual intercourse for 24 hours prior to the Pap test.
• D. Viral infections cannot be detected by a Pap test.

Correct answer: C

Rationale: Clients should avoid sexual intercourse for 24 hours prior to the Pap test to ensure accurate results, as it can affect the sample. This is important for obtaining reliable results. Choice A is incorrect because a yearly Pap test is not the standard recommendation for all age groups; instead, it is typically every 3 years for women aged 21-29 and every 3-5 years for women aged 30-65. Choice B is incorrect because Pap tests are not necessarily discontinued following removal of the ovaries; they may still be needed based on the individual's health history and provider recommendations. Choice D is incorrect because while Pap tests are primarily used to detect abnormal cervical cells and cervical cancer, they do not detect viral infections.

5. A nurse is caring for a client prescribed montelukast. Which of the following should the nurse include in teaching related to this medication?

• A. Advise the client to take the medication once daily at bedtime.
• B. This medication is for acute management of asthma.
• C. Avoid dairy products while taking this medication.
• D. If the client forgets to take the medication for a few days, he can double up on doses to catch up.

Correct answer: A

Rationale: The correct answer is to advise the client to take the medication once daily at bedtime. Montelukast, a leukotriene modifier, is used for long-term therapy of asthma in adults and children, as well as to prevent exercise-induced bronchospasm. It should be taken once daily in the evening for optimal effectiveness. Choice B is incorrect because montelukast is not for acute management but for long-term therapy. Choice C is incorrect as there is no need to avoid dairy products while taking montelukast. Choice D is incorrect and potentially harmful advice; clients should never double up on doses if they forget to take a medication.

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