Nursing Elites

1. While documenting client care, which of the following entries should the nurse identify as an example of implementing client care?

• A. Contacting the provider to report client findings
• B. Administering medications as prescribed
• C. Reviewing the client's lab results
• D. Discussing the care plan with the family

Correct answer: B

Rationale: Administering medications as prescribed is a clear example of implementing client care because it involves carrying out a specific aspect of the care plan. Contacting the provider to report client findings is more related to assessment and communication. Reviewing the client's lab results is part of assessment and data collection. Discussing the care plan with the family is focused on collaboration and planning, rather than direct implementation.

2. Which of the following interventions is most appropriate for a client with hyperemesis gravidarum?

• A. Encourage high-calorie meals
• B. Administer intravenous fluids
• C. Provide frequent small meals
• D. Limit fluid intake

Correct answer: B

Rationale: The correct answer is B: Administer intravenous fluids. Hyperemesis gravidarum is severe, persistent nausea and vomiting during pregnancy that can lead to dehydration and electrolyte imbalances. The priority intervention is to administer intravenous fluids to maintain hydration. Encouraging high-calorie meals (Choice A) may exacerbate symptoms due to increased gastric stimulation. Providing frequent small meals (Choice C) may not be effective in severe cases where continuous vomiting occurs. Limiting fluid intake (Choice D) is contraindicated in hyperemesis gravidarum as dehydration is a significant concern.

3. A client is prescribed metronidazole for a bacterial infection. Which of the following should the nurse teach the client?

• A. Avoid alcohol while taking this medication
• B. It is safe to take during pregnancy
• C. Monitor for increased appetite
• D. It can cause hair loss

Correct answer: A

Rationale: The correct answer is A: 'Avoid alcohol while taking this medication.' Metronidazole can cause a disulfiram-like reaction with alcohol, leading to symptoms like nausea, vomiting, flushing, and headache. Therefore, clients should be instructed to avoid alcohol consumption. Choice B is incorrect because metronidazole is not considered safe during pregnancy, especially in the first trimester. Choice C is incorrect as metronidazole is not known to cause increased appetite. Choice D is also incorrect as hair loss is not a common side effect of metronidazole.

4. A nurse has been caring for a female client who has bruises on her arms that she explains are a result of physical abuse by her husband. The client states, “I don’t know how much longer I can take this, but I’m afraid he’ll really hurt me if I leave.” Which of the following is an appropriate nursing intervention?

• A. Offer to speak to the client’s husband regarding his abusive behavior
• B. Help the client to recognize signs of escalation in abusive behavior
• C. Assist the client in identifying personal behaviors that trigger abuse
• D. Assist the client in reporting the abusive behavior to authorities

Correct answer: D

Rationale: Assisting the client in reporting the abuse is a critical step in ensuring her safety and initiating legal action to protect her from further harm. Option A is inappropriate as it may escalate the situation and put the client at further risk. Option B focuses on the client recognizing signs of abuse, which is not as urgent as reporting it to authorities. Option C places the responsibility on the client for triggering the abuse, which is victim-blaming and not helpful in this context.

5. A client has been prescribed enoxaparin. Which of the following instructions should the nurse provide regarding self-administration?

• A. Pinch the skin and inject at a 45-degree angle
• B. Massage the injection site after administering
• C. Administer at a 90-degree angle
• D. Avoid rotating injection sites

Correct answer: A

Rationale: The correct answer is to pinch the skin and inject at a 45-degree angle when administering enoxaparin. This technique helps ensure proper administration of the medication. Massaging the injection site after administering is unnecessary and could increase the risk of bleeding. Administering at a 90-degree angle is not recommended for enoxaparin injections. Rotating injection sites is important to prevent tissue damage and irritation.

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