Nursing Elites

1. A healthcare professional is reviewing the arterial blood gas results for a client in the ICU who has kidney failure and determines the client has respiratory acidosis. Which of the following findings should the healthcare professional expect?

• A. Widened QRS complexes
• B. Hyperactive deep tendon reflexes
• C. Bounding peripheral pulses
• D. Warm, flushed skin

Correct answer: A

Rationale: Respiratory acidosis is characterized by an increase in carbon dioxide levels in the blood, leading to acidosis. This condition can affect the heart's electrical conduction system, resulting in widened QRS complexes on an electrocardiogram (ECG). Hyperactive deep tendon reflexes, bounding peripheral pulses, and warm, flushed skin are not typically associated with respiratory acidosis.

2. A nurse in an antepartum unit is triaging clients. Which of the following clients should the nurse see first?

• A. A client who is at 38 weeks of gestation and reports a cough and fever
• B. A client who has missed a period and reports vaginal spotting
• C. A client who is at 14 weeks of gestation and reports nausea and vomiting
• D. A client who is at 28 weeks of gestation and reports of painless vaginal bleeding

Correct answer: D

Rationale:

3. A client who experienced a cesarean birth due to dysfunctional labor expresses disappointment for not having a natural childbirth. Which response should the nurse make?

• A. Validate the client's feelings by saying, 'It sounds like you are feeling sad that things didn't go as planned.'
• B. Assure the client by stating, 'At least you know you have a healthy baby.'
• C. Encourage the client by suggesting, 'Maybe next time you can have a vaginal delivery.'
• D. Provide information by saying, 'You can resume sexual relations sooner than if you had delivered vaginally.'

Correct answer: A

Rationale: The correct response is to acknowledge and validate the client's feelings of disappointment. This empathetic approach demonstrates understanding and support for the client's emotional state, fostering a therapeutic nurse-client relationship. Options B, C, and D do not address the client's emotional needs or provide appropriate support in this situation.

4. A client at 37 weeks of gestation with severe gestational hypertension is being admitted by a nurse. Which of the following actions should the nurse NOT expect to implement?

• A. Administer magnesium sulfate IV.
• B. Provide a dark, quiet environment.
• C. Assess respiratory status every 4 hours.
• D. Ensure that calcium gluconate is readily available.

Correct answer: C

Rationale: Assessing respiratory status every 4 hours is not a priority for a client with severe gestational hypertension. In this scenario, the focus should be on monitoring blood pressure, assessing for signs of preeclampsia, administering medications like magnesium sulfate for seizure prophylaxis, and ensuring that calcium gluconate is readily available in case of magnesium toxicity. Respiratory status assessment is important in other conditions but is not directly related to managing severe gestational hypertension.

5. A client in a prenatal clinic is being taught by a nurse in her second trimester with a new diagnosis of gestational diabetes. Which of the following client statements indicates a need for further teaching?

• A. I should limit my carbohydrates to 50% of caloric intake.
• B. I will reduce my exercise schedule to 3 days a week.
• C. I will take my glyburide daily with breakfast.
• D. I know I am at increased risk of developing type 2 diabetes.

Correct answer: B

Rationale: Choice B, 'I will reduce my exercise schedule to 3 days a week,' indicates a need for further teaching. Regular exercise is beneficial in managing gestational diabetes and should not be reduced without proper guidance. Choices A, C, and D demonstrate understanding and appropriate actions in managing gestational diabetes.

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