Nursing Elites

1. A nurse is teaching a client who is lactose intolerant about dietary choices. Which food should the nurse recommend to increase calcium intake?

• A. Spinach
• B. Peanut butter
• C. Ground beef
• D. Carrots

Correct answer: A

Rationale: The correct answer is A: Spinach. Spinach is rich in calcium, making it a suitable choice for individuals with lactose intolerance who need to avoid dairy products. Peanut butter, ground beef, and carrots are not significant sources of calcium compared to spinach, and therefore, not the best recommendation for increasing calcium intake in lactose-intolerant individuals.

2. A nurse is caring for a client who is in active labor. The nurse notes early decelerations in the FHR on the fetal monitor tracing. The nurse should identify that which of the following conditions causes early decelerations in the FHR?

• A. Fetal hypoxemia
• B. Cord compression
• C. Uteroplacental insufficiency
• D. Head compression

Correct answer: D

Rationale: Early decelerations are caused by head compression during contractions, which is a normal response as the fetal head is being compressed during uterine contractions. This usually indicates that the fetus is descending into the birth canal. Choices A, B, and C are incorrect. Fetal hypoxemia, cord compression, and uteroplacental insufficiency typically present with variable or late decelerations on the fetal heart rate tracing, not early decelerations.

3. A nurse is caring for a client who is receiving oxytocin to augment labor. The client has an intrauterine pressure catheter and an internal fetal scalp electrode for monitoring. Which of the following is an indication that the nurse should discontinue the infusion?

• A. Contraction frequency every 3 minutes
• B. Contraction duration of 100 seconds
• C. Fetal heart rate with moderate variability
• D. Fetal heart rate of 118/min

Correct answer: B

Rationale: A contraction duration of 100 seconds indicates potential uterine hyperstimulation, which can lead to fetal distress and decreased uterine perfusion. Prolonged contractions may reduce oxygen supply to the fetus, putting it at risk. Discontinuing the oxytocin infusion is crucial to prevent adverse effects on both the mother and the fetus. The other options do not raise immediate concerns that would necessitate discontinuing the oxytocin infusion. Contraction frequency every 3 minutes is within a normal range. Fetal heart rate with moderate variability and a rate of 118/min are both reassuring signs of fetal well-being.

4. A client with chronic kidney disease is being educated by a nurse about managing their condition. Which of the following statements shows an understanding of the teaching?

• A. I will need to take an iron supplement.
• B. I will consume foods high in phosphorus.
• C. I will reduce my intake of carbohydrates.
• D. I will monitor my blood glucose level daily.

Correct answer: A

Rationale: The correct answer is A. Clients with chronic kidney disease often develop anemia due to reduced erythropoietin production, leading to decreased red blood cell production. Iron supplementation is frequently required to enhance red blood cell production. Choices B, C, and D are incorrect because in chronic kidney disease, there is a need to restrict phosphorus intake, control carbohydrate intake for blood sugar management, and monitor electrolytes and fluid balance rather than blood glucose levels.

5. A nurse in an emergency department is serving on a committee that is reviewing the facility protocol for disaster readiness. The nurse should recommend that the protocol include which of the following as a clinical manifestation of smallpox?

• A. Bloody diarrhea
• B. Ptosis of the eyelids
• C. Descending paralysis
• D. Rash in the mouth

Correct answer: D

Rationale: The correct answer is D, 'Rash in the mouth.' Smallpox presents with a distinctive rash that typically begins in the mouth and spreads to the rest of the body, developing into pustules. This rash is a key clinical manifestation of smallpox. This infectious disease is characterized by the rash, fever, and other systemic symptoms. Choices A, B, and C are incorrect because they are not associated with smallpox. Bloody diarrhea, ptosis of the eyelids, and descending paralysis are not typical clinical manifestations of smallpox.

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