Nursing Elites

1. A 65-year-old female client is experiencing postmenopausal bleeding. Which type of physician should this client be encouraged to see?

• A. a radiologist
• B. a gynecologist
• C. a physiatrist
• D. an oncologist

Correct answer: B

Rationale: A gynecologist is the appropriate physician for this scenario as they specialize in treating and managing diseases of the female reproductive system, including postmenopausal bleeding. Postmenopausal bleeding can indicate serious conditions such as endometrial cancer, which a gynecologist can evaluate and manage. A radiologist primarily evaluates X-rays and imaging studies, not directly involved in managing gynecological issues. A physiatrist is a specialist in physical medicine and rehabilitation, not related to gynecological concerns. An oncologist specializes in diagnosing and treating cancer, which is not the primary concern in this case of postmenopausal bleeding.

2. The LPN is taking care of a 176-pound client who has recently been diagnosed with diabetes. The primary healthcare provider has written an order for Lantus� (insulin glargine injection) 100 units/mL, using weight-based dosing of 0.2 units/kg per day. The LPN should prepare ____ units for administration.

• A. 12
• B. 35
• C. 16
• D. 9

Correct answer: B

Rationale: To calculate the correct dosage, first convert the client's weight from pounds to kilograms. As 1 kg = 2.2 pounds, 176 pounds � 2.2 = 80 kg. The client should receive 0.2 units for every kilogram, which equals 16 units. Therefore, the total amount to prepare is 16 units x 100 units/mL = 1600 units. Considering the medication concentration of 100 units/mL, 1600 units � 100 units/mL = 16 mL. However, since the question asks for the number of units, the final answer is 16 units x 2 injections = 32 units. Therefore, the LPN should prepare 32 units for administration.

3. Which of the following is most likely to impact the body image of an infant newly diagnosed with Hemophilia?

• A. immobility
• B. altered growth and development
• C. hemarthrosis
• D. altered family processes

Correct answer: D

Rationale: Altered Family Processes is a significant factor that can impact the body image of an infant newly diagnosed with Hemophilia. Infants are highly sensitive to the reactions of their caregivers, and a new diagnosis like Hemophilia can introduce stress and uncertainties into the family dynamics. This can affect the infant's sense of security, trust development, and how they perceive themselves. Immobility, while a potential long-term effect of Hemophilia, is not the immediate impact on body image for a newly diagnosed infant. Altered growth and development would take time to manifest and would not be an immediate concern after a recent diagnosis. Hemarthrosis, although a characteristic symptom of Hemophilia, is a physical manifestation rather than a direct influence on body image perception in a newly diagnosed infant.

4. Which of the following values should be monitored closely while a client is on total parenteral nutrition?

• A. calcium
• B. magnesium
• C. glucose
• D. cholesterol

Correct answer: C

Rationale: Glucose is the correct value to monitor closely while a client is on total parenteral nutrition. Total parenteral nutrition solutions have high glucose concentrations, necessitating monitoring to prevent complications like hyperglycemia. Calcium, magnesium, and cholesterol are not typically closely monitored during total parenteral nutrition as they are not directly related to the solution's composition or potential associated complications.

5. A client with peripheral artery disease tells the nurse that pain develops in his left calf when he is walking and subsides with rest. The nurse documents that the client is most likely experiencing which disorder?

• A. Venous insufficiency
• B. Intermittent claudication
• C. Sore muscles from overexertion
• D. Muscle cramps related to musculoskeletal problems

Correct answer: B

Rationale: Leg pain characteristic of peripheral artery disease is known as intermittent claudication. The client can walk only a certain distance before cramping, burning, muscle discomfort, or pain forces them to stop, with the pain subsiding after rest. The pain is reproducible, and as the disease progresses, the client can walk shorter distances before the pain recurs. Ultimately, pain may even occur at rest. Venous insufficiency (Choice A) involves impaired blood flow in the veins, leading to swelling and skin changes but not typically pain associated with exercise. Sore muscles from overexertion (Choice C) and muscle cramps related to musculoskeletal problems (Choice D) do not present with the characteristic pattern of pain associated with peripheral artery disease.

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