Nursing Elites

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

• A. It can cause weight loss
• B. Monitor for mood changes
• C. It is an over-the-counter medication
• D. It has no side effects

Correct answer: B

Rationale: The correct answer is B. Levetiracetam can cause mood changes and behavioral side effects, so clients should be monitored for these effects. Choice A is incorrect because levetiracetam is not typically associated with weight loss. Choice C is incorrect as levetiracetam is a prescription medication, not available over the counter. Choice D is incorrect as all medications, including levetiracetam, have potential side effects.

2. A nurse is caring for a client who is 36 weeks pregnant and reports leaking fluid. Which of the following tests should the nurse use to confirm that the client's membranes have ruptured?

• A. Nonstress test
• B. Biophysical profile
• C. Fern test
• D. Amniocentesis

Correct answer: C

Rationale: The correct answer is the Fern test. The Fern test is specifically used to confirm the rupture of membranes. A sample of vaginal fluid is examined under a microscope, and the presence of a fern-like pattern indicates the presence of amniotic fluid. The Nonstress test (Choice A) is used to monitor fetal heart rate and movement, not to confirm ruptured membranes. The Biophysical profile (Choice B) is a prenatal ultrasound evaluation to assess fetal well-being, not to confirm ruptured membranes. Amniocentesis (Choice D) involves the aspiration of amniotic fluid for various diagnostic purposes, not specifically to confirm ruptured membranes.

3. A nurse is caring for a client receiving oxytocin IV for labor augmentation. The client’s contractions are occurring every 45 seconds and lasting 90 seconds. What action should the nurse take?

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

Correct answer: A

Rationale: In this scenario, the client is experiencing uterine hyperstimulation with contractions every 45 seconds lasting 90 seconds. This frequency and duration of contractions can lead to fetal distress. The appropriate nursing action is to discontinue the oxytocin infusion immediately to prevent complications. Increasing or maintaining the oxytocin infusion would exacerbate the situation, while decreasing it may not be sufficient to address the issue effectively.

4. A nurse is assessing a client who has diabetic ketoacidosis (DKA). Which of the following laboratory findings should the nurse expect?

• A. Blood glucose 120 mg/dL
• B. pH 7.32
• C. HCO3 25 mEq/L
• D. PaCO2 48 mm Hg

Correct answer: B

Rationale: The correct answer is B. A pH of 7.32 indicates metabolic acidosis, which is a hallmark of diabetic ketoacidosis (DKA). In DKA, blood glucose levels are typically elevated, bicarbonate levels are often low, and there is a compensatory respiratory response leading to a decrease in PaCO2. Option A is incorrect because a blood glucose level of 120 mg/dL is within the normal range and not indicative of DKA. Option C is incorrect because an HCO3 level of 25 mEq/L is not typically seen in DKA where bicarbonate levels are usually lower. Option D is incorrect because a PaCO2 of 48 mm Hg would not be expected in DKA; it would typically be lower due to compensatory respiratory alkalosis.

5. A nurse is caring for a client who has been prescribed furosemide. Which of the following foods should the nurse encourage the client to include in their diet?

• A. Table salt
• B. Egg yolks
• C. White wine
• D. Oranges

Correct answer: D

Rationale: Furosemide is a potassium-wasting diuretic, so clients should consume potassium-rich foods like oranges to prevent hypokalemia. Oranges are a good source of potassium. Table salt, egg yolks, and white wine do not provide significant amounts of potassium and are not beneficial for a client taking furosemide.

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