Nursing Elites

1. A client who is at 30 weeks of gestation and is scheduled for a nonstress test is being taught by a nurse. Which of the following statements by the client indicates an understanding of the teaching?

• A. I should avoid drinking fluids during the test.
• B. I will need to drink a sugar solution before the test.
• C. This test will monitor how my baby is responding to contractions.
• D. This test will assess for fetal lung maturity.

Correct answer: B

Rationale: The correct answer is B because the client should drink a sugar solution for a glucose challenge test, which is part of the nonstress test protocol during pregnancy. Choice A is incorrect because adequate hydration is generally recommended before the test. Choice C is incorrect as the nonstress test monitors the baby's heart rate in response to its own movements, not contractions. Choice D is incorrect as the nonstress test does not assess fetal lung maturity.

2. A client with diabetes mellitus is being taught by a nurse on managing hypoglycemia. Which of the following instructions should the nurse include?

• A. Avoid consuming carbohydrate-rich foods.
• B. Consume 15 grams of a fast-acting carbohydrate.
• C. Drink a glass of water to raise blood glucose levels.
• D. Eat a snack before exercising to prevent hypoglycemia.

Correct answer: B

Rationale: The correct answer is B: Consume 15 grams of a fast-acting carbohydrate. Consuming 15 grams of a fast-acting carbohydrate, such as glucose tablets or juice, helps raise blood glucose levels quickly in cases of hypoglycemia. Choice A is incorrect because avoiding carbohydrate-rich foods during hypoglycemia can worsen the condition. Choice C is incorrect as drinking water does not effectively raise blood glucose levels. Choice D is incorrect as eating a snack before exercising is more related to preventing exercise-induced hypoglycemia, not managing hypoglycemia.

3. A client with a new diagnosis of celiac disease is receiving teaching from a nurse. Which of the following client statements indicates an understanding of the teaching?

• A. I can still have oatmeal for breakfast.
• B. I need to avoid foods that contain gluten.
• C. I can have rye toast with my eggs.
• D. I can continue to eat foods made from barley.

Correct answer: B

Rationale: The correct answer is B because clients with celiac disease should avoid gluten, which is found in foods like rye and barley. Choice A is incorrect because oatmeal may contain gluten unless specified gluten-free. Choice C is incorrect as rye contains gluten. Choice D is incorrect as barley contains gluten.

4. While caring for a client receiving total parenteral nutrition (TPN), which of the following actions should the nurse take?

• A. Monitor the client's urine output every 8 hours.
• B. Administer a bolus of 0.9% sodium chloride.
• C. Check the client's blood glucose level every 4 hours.
• D. Flush the TPN line with sterile water before and after administration.

Correct answer: C

Rationale: Checking the client's blood glucose level every 4 hours is essential when managing a client on TPN to monitor for hyperglycemia, a common complication. Monitoring urine output (Choice A) is important but not a priority in this scenario. Administering a bolus of 0.9% sodium chloride (Choice B) is not indicated as it is unrelated to managing TPN. Flushing the TPN line with sterile water (Choice D) is necessary, but it should be done with 0.9% sodium chloride, not water.

5. A nurse is preparing to administer dopamine hydrochloride 4 mcg/kg/min via continuous infusion. The client weighs 80 kg. How many mL/hr should the nurse set the IV infusion to deliver?

• A. 6 mL/hr
• B. 8 mL/hr
• C. 12 mL/hr
• D. 16 mL/hr

Correct answer: A

Rationale: To calculate the correct rate, use the formula: (4 mcg/kg/min * 80 kg) / 800 mcg in 250 mL = 6 mL/hr. This calculation is based on the dose ordered (4 mcg/kg/min) multiplied by the patient's weight in kg (80 kg), divided by the concentration of the drug available (800 mcg in 250 mL) to be infused over 1 hour. Therefore, the correct answer is 6 mL/hr. Choices B, C, and D are incorrect as they do not reflect the accurate calculation based on the provided information.

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