Nursing Elites

1. A nurse is providing teaching to a client who is at 34 weeks of gestation and is scheduled for a nonstress test. Which of the following statements should the nurse plan to make?

• A. You will not receive medication through an IV for this test.
• B. You should expect the test to take about 30 minutes.
• C. You do not need to eat or drink for 4 hours prior to the test.
• D. This test will help determine if your baby's lungs are mature.

Correct answer: B

Rationale: The correct statement for the nurse to make is choice B, 'You should expect the test to take about 30 minutes.' The nonstress test is used to assess fetal well-being by monitoring fetal heart rate in response to movements. Choice A is incorrect because medications are not typically administered during a nonstress test. Choice C is incorrect as there is no need for the client to fast before the test. Choice D is incorrect because determining fetal lung maturity is usually done through other tests, not the nonstress test.

2. A nurse is teaching a group of clients about stress management. Which of the following activities should the nurse recommend to reduce stress?

• A. Watching television
• B. Deep breathing exercises
• C. Drinking coffee
• D. Avoiding exercise

Correct answer: B

Rationale: Deep breathing exercises are effective in reducing stress by promoting relaxation and lowering heart rate, making them a recommended technique. Watching television may not actively reduce stress but can serve as a distraction. Drinking coffee, which contains caffeine, may increase anxiety levels. Avoiding exercise can lead to pent-up stress and tension rather than reducing it.

3. A nurse is preparing to administer a dose of escitalopram. Which of the following should the nurse assess first?

• A. Mood changes
• B. Blood pressure
• C. Heart rate
• D. Liver function

Correct answer: A

Rationale: The correct answer is to assess for mood changes. When administering escitalopram, it is crucial to evaluate mood changes first because the medication may take some time to demonstrate its full effects on the patient's mood. Assessing blood pressure, heart rate, or liver function is not the priority when administering escitalopram, as these parameters are not directly impacted acutely by this medication.

4. A nurse is providing teaching for a client who has a new prescription for sertraline. Which of the following statements by the client indicates understanding?

• A. I will feel better immediately after starting this medication.
• B. I can expect to urinate frequently while taking this medication.
• C. I may experience difficulty sleeping while taking this medication.
• D. I should decrease my sodium intake while taking this medication.

Correct answer: C

Rationale: The correct answer is C: 'I may experience difficulty sleeping while taking this medication.' Sertraline can cause insomnia, especially when first starting the medication, so the client should be aware of this potential side effect. Choices A, B, and D are incorrect because feeling better immediately, increased urination, and decreasing sodium intake are not commonly associated side effects of sertraline.

5. A nurse is supervising an LPN who is providing care to a patient who is postoperative. Which of the following statements by the patient requires the nurse to follow up with the LPN?

• A. “I am experiencing some pain, but it’s tolerable.”
• B. “The nurse checked my vital signs earlier.”
• C. “I have not received any of my medications today.”
• D. “I am scheduled for therapy later today.”

Correct answer: C

Rationale: If the patient states they have not received any medications, it requires immediate follow-up to prevent missed doses and complications. The other options do not pose an immediate risk to the patient. Option A indicates pain but is tolerable, which is a common postoperative experience. Option B states that vital signs were checked, indicating ongoing monitoring. Option D mentions therapy, which is a scheduled activity and not an urgent concern regarding medication administration.

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