Nursing Elites

1. A patient with anemia is prescribed ferrous sulfate. What advice should the nurse give regarding the administration of this medication?

• A. Take with dairy products to increase absorption.
• B. Take on an empty stomach for best absorption.
• C. Avoid vitamin C while taking this medication.
• D. Take before bedtime.

Correct answer: B

Rationale: The correct advice for the administration of ferrous sulfate is to take it on an empty stomach for best absorption. This enhances the absorption of iron. If gastrointestinal upset occurs, the medication can be taken with food. Taking ferrous sulfate with dairy products is not recommended as calcium can inhibit iron absorption. Taking it before bedtime is also not recommended. Vitamin C can actually help with the absorption of iron and is often recommended to be taken alongside iron supplements to enhance absorption. Therefore, avoiding vitamin C while taking ferrous sulfate is not correct.

2. A patient with rheumatoid arthritis is prescribed methotrexate. What is an important teaching point for the nurse to provide?

• A. Take folic acid supplements as prescribed.
• B. Avoid alcohol completely.
• C. Expect to see immediate results.
• D. Limit fluid intake to 1 liter per day.

Correct answer: A

Rationale: The correct teaching point for a patient prescribed methotrexate is to take folic acid supplements as prescribed. Methotrexate can lead to a folate deficiency, which is why supplementing with folic acid is essential to reduce the risk of side effects such as mouth sores, nausea, and liver problems.

3. A 60-year-old man presents with fatigue, weight gain, and constipation. Laboratory tests reveal low TSH and high free T4 levels. What is the most likely diagnosis?

• A. Hypothyroidism
• B. Hyperthyroidism
• C. Thyroiditis
• D. Thyroid cancer

Correct answer: B

Rationale: The combination of low TSH and high free T4 levels is characteristic of hyperthyroidism, not hypothyroidism. Hyperthyroidism is associated with symptoms such as fatigue, weight loss, and diarrhea, contrasting with the typical presentation of hypothyroidism. Therefore, in this case, the most likely diagnosis is hyperthyroidism.

4. A client in labor states, 'I think my water just broke!' The nurse notes that the umbilical cord is on the perineum. What action should the nurse perform first?

• A. Administer oxygen via face mask.
• B. Notify the operating room team.
• C. Place the client in Trendelenburg.
• D. Administer a fluid bolus of 500 ml.

Correct answer: C

Rationale: In this scenario, the priority action for the nurse is to place the client in Trendelenburg position. This position helps alleviate pressure on the umbilical cord, preventing compression and ensuring continued blood flow to the fetus. Administering oxygen, notifying the operating room team, or administering a fluid bolus are not the initial priority actions in a cord prolapse situation.

5. The client with newly diagnosed hypertension is being taught about lifestyle modifications. Which recommendation should be made?

• A. Increase your intake of saturated fats.
• B. Limit your alcohol intake to two drinks per day.
• C. Engage in at least 150 minutes of moderate exercise per week.
• D. Use table salt liberally to season your food.

Correct answer: C

Rationale: Engaging in at least 150 minutes of moderate exercise per week is a key lifestyle modification recommended for individuals with hypertension. Regular exercise helps manage blood pressure, improve cardiovascular health, and overall well-being. It is important for the client to adopt a healthy lifestyle to control hypertension and reduce the risk of complications.

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