Nursing Elites

1. A nurse is teaching a client about the use of clopidogrel. Which of the following should be included?

• A. It is an anticoagulant
• B. Monitor for signs of bleeding
• C. It can be stopped abruptly
• D. Avoid foods rich in vitamin K

Correct answer: B

Rationale: The correct answer is B: 'Monitor for signs of bleeding.' Clopidogrel is an antiplatelet medication, not an anticoagulant. Clients taking clopidogrel should be monitored for signs of bleeding due to its antiplatelet effects. Choice A is incorrect because clopidogrel is not an anticoagulant. Choice C is incorrect as clopidogrel should not be stopped abruptly but as directed by a healthcare provider. Choice D is irrelevant since foods rich in vitamin K are more of a concern with anticoagulant medications like warfarin, not antiplatelet medications like clopidogrel.

2. 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.

3. A client with a cystocele is encouraged to exercise to strengthen pelvic floor muscles and prevent pelvic organ prolapse. What exercise will the client need to perform?

• A. Kegel exercises
• B. Isometric exercises
• C. Circumduction exercises
• D. Uterine extension exercises

Correct answer: A

Rationale: Corrected Rationale: The client with a cystocele should perform Kegel exercises to strengthen the pelvic floor muscles, reducing the risk of pelvic organ prolapse and stress urinary incontinence. Kegel exercises specifically target the muscles that support the pelvic organs. Isometric exercises focus on static muscle contractions and may not be as effective as Kegel exercises for strengthening the pelvic floor. Circumduction exercises involve circular movements at joints and are not specific to pelvic floor muscle strengthening. Uterine extension exercises do not directly target the pelvic floor muscles and are not indicated for cystocele management.

4. A nurse is teaching a client about fecal occult blood testing (FOBT) for the screening of colorectal cancer. Which of the following statements should the nurse include in the teaching?

• A. “Your provider will use stool samples from your bowel movement to perform the test.”
• B. “Your provider will prescribe a stimulant laxative prior to the procedure to cleanse the bowel.”
• C. “You should begin biennial fecal occult blood testing for colorectal cancer screening at 50 years old.”
• D. “You should avoid taking corticosteroids prior to testing.”

Correct answer: D

Rationale: The correct answer is D. The nurse should instruct the client to avoid corticosteroids and vitamin C prior to testing to prevent false-positive results. Choice A is incorrect because stool samples from bowel movements, not from digital rectal examinations, are used for FOBT. Choice B is incorrect because a stimulant laxative is not typically prescribed before FOBT; rather, the client is instructed to follow specific dietary restrictions. Choice C is incorrect because biennial fecal occult blood testing for colorectal cancer screening usually begins at 50 years old, not 40.

5. A client is receiving oxytocin to augment labor. The contractions are occurring every 45 seconds, and the fetal heart rate is 170-180 beats/min. What action should the nurse take?

• A. Increase the oxytocin infusion
• B. Decrease the oxytocin infusion
• C. Discontinue the oxytocin infusion
• D. Maintain the oxytocin infusion

Correct answer: C

Rationale: When contractions occur every 45 seconds with a high fetal heart rate, it indicates uterine hyperstimulation and fetal distress. In this situation, the oxytocin infusion should be discontinued immediately to prevent further complications. Increasing or maintaining the infusion would worsen the hyperstimulation and distress. Decreasing the infusion may not be sufficient to address the current situation and could still lead to complications.

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