Nursing Elites

1. A client with a new diagnosis of peptic ulcer disease is receiving teaching from a nurse. Which of the following statements by the client indicates an understanding of the teaching?

• A. I will avoid taking ibuprofen for my pain.
• B. I will avoid eating spicy foods.
• C. I will limit my intake of dairy products.
• D. I will take my antacids 30 minutes before meals.

Correct answer: B

Rationale: The correct answer is B. Clients with peptic ulcer disease should avoid spicy foods as they can exacerbate symptoms and delay healing. Ibuprofen can worsen peptic ulcers by irritating the stomach lining, so it should be avoided. While limiting dairy products may be beneficial for some individuals with lactose intolerance, it is not a specific recommendation for peptic ulcer disease. Taking antacids before meals can help neutralize stomach acid; however, the timing may vary depending on the type of antacid, so there is no universal rule of taking antacids 30 minutes before meals. Choice A is incorrect because the client should avoid taking ibuprofen due to its potential to worsen peptic ulcers. Choice C is incorrect as there is no direct correlation between dairy product intake and peptic ulcer disease. Choice D is incorrect because the timing of antacid administration can vary and should be guided by specific recommendations.

2. Which lab value should be monitored in patients receiving heparin therapy?

• A. Monitor aPTT
• B. Monitor INR
• C. Monitor platelet count
• D. Monitor sodium levels

Correct answer: A

Rationale: The correct answer is to monitor aPTT in patients receiving heparin therapy. Activated Partial Thromboplastin Time (aPTT) is crucial to assess the therapeutic effectiveness of heparin and to prevent bleeding complications. Monitoring INR (Choice B) is more relevant for patients on warfarin therapy, not heparin. Platelet count (Choice C) monitoring is essential for detecting heparin-induced thrombocytopenia rather than assessing heparin therapy itself. Monitoring sodium levels (Choice D) is not directly related to heparin therapy monitoring.

3. A client in active labor has ruptured membranes. What action should the nurse take?

• A. Apply a fetal heart rate monitor.
• B. Initiate fundal massage.
• C. Administer oxytocin IV.
• D. Insert an indwelling urinary catheter.

Correct answer: A

Rationale: When a client in active labor has ruptured membranes, the priority action for the nurse is to apply a fetal heart rate monitor. This is crucial for continuous monitoring of the baby's heart rate and ensuring fetal well-being. Initiating fundal massage may be indicated for uterine atony after delivery, not for ruptured membranes during labor. Administering oxytocin IV could be appropriate in some cases to augment labor, but it is not the immediate priority after ruptured membranes. Inserting an indwelling urinary catheter is not necessary solely based on ruptured membranes; it may be indicated for specific situations like epidural anesthesia where the client cannot void.

4. A nurse is assessing a client who is postoperative following a bowel resection. Which of the following findings should the nurse report to the provider?

• A. Heart rate 110/min.
• B. Temperature of 37.4°C (99.3°F).
• C. Respiratory rate of 18/min.
• D. Urine output of 20 mL/hr.

Correct answer: D

Rationale: A urine output of 20 mL/hr is below the expected range and indicates potential renal failure, requiring immediate intervention. In postoperative patients, a urine output less than 30 mL/hr suggests inadequate renal perfusion, a concern that needs prompt attention to prevent renal complications. The heart rate of 110/min, temperature of 37.4°C (99.3°F), and respiratory rate of 18/min are within normal ranges for a postoperative client and do not indicate immediate issues.

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

• A. Heart rate of 78/min.
• B. Vision changes.
• C. Respiratory rate of 16/min.
• D. Blood pressure of 120/80 mm Hg.

Correct answer: B

Rationale: The correct answer is B: Vision changes. Vision changes are a classic sign of digoxin toxicity and should be reported immediately to the provider for further evaluation and management. A heart rate of 78/min, a respiratory rate of 16/min, and a blood pressure of 120/80 mm Hg are within normal ranges and are not typically associated with digoxin toxicity. Therefore, they would not be the priority findings to report in this situation.

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