Nursing Elites

1. A charge nurse is making assignments for the upcoming shift. What assignment should the charge nurse give to an LPN?

• A. A client who requires complex medication management
• B. A client who has dehydration and inflammatory bowel disease (IBD)
• C. A client needing assessment of a new diagnosis
• D. A client requiring a nursing care plan update

Correct answer: B

Rationale: The correct assignment for an LPN would be a client who has dehydration and inflammatory bowel disease (IBD). This choice is appropriate because it involves monitoring the client's condition, providing basic care, and assisting with activities of daily living, which align with the scope of practice for LPNs. Choices A, C, and D involve tasks that are more complex and require a higher level of nursing education and training, making them less suitable for an LPN.

2. A nurse is caring for a client who has breast cancer and has been receiving chemotherapy. Which of the following laboratory values should the nurse report to the provider?

• A. WBC 3,000/mm3
• B. Hemoglobin 14 g/dL
• C. Platelets 250,000/mm3
• D. aPTT 30 seconds

Correct answer: A

Rationale: A WBC count of 3,000/mm3 indicates neutropenia, a dangerous complication of chemotherapy that increases the risk of infection and requires immediate attention. Neutropenia is a common side effect of chemotherapy and can lead to life-threatening infections. Reporting a low WBC count is crucial to ensure timely intervention. Choices B, C, and D are within normal ranges and do not pose immediate risks to the client undergoing chemotherapy.

3. During a change-of-shift assessment, a nurse is evaluating four clients. Which finding should the nurse report to the provider first?

• A. A client with cystic fibrosis who has a productive cough and reports thirst
• B. A client with gastroenteritis who is lethargic and confused
• C. A client with diabetes mellitus whose blood glucose is 185 mg/dL
• D. A client with sickle cell anemia who reports pain 15 minutes after receiving analgesics

Correct answer: B

Rationale: Lethargy and confusion in a client with gastroenteritis are concerning findings that may indicate severe dehydration or electrolyte imbalance, requiring immediate intervention. While the other options are important, they do not pose an immediate life-threatening risk compared to the altered mental status in a client with gastroenteritis.

4. A nurse is preparing to administer a blood transfusion. Which of the following actions should the nurse take first?

• A. Obtain the client's consent
• B. Verify the blood type and crossmatch
• C. Take baseline vital signs
• D. Prime the IV with normal saline

Correct answer: B

Rationale: The correct first action the nurse should take when preparing to administer a blood transfusion is to verify the blood type and crossmatch. This step is crucial to ensure compatibility and prevent transfusion reactions. Obtaining the client's consent is important but should follow the verification process. Taking baseline vital signs is necessary before starting the transfusion, but confirming compatibility takes precedence. Priming the IV with normal saline is a step done before starting the transfusion, after ensuring blood compatibility.

5. A healthcare professional is preparing to administer a dose of sertraline. Which of the following should the healthcare professional assess first?

• A. Blood pressure
• B. Heart rate
• C. Respiratory rate
• D. Mood changes

Correct answer: A

Rationale: When administering sertraline, assessing blood pressure is crucial as this medication can potentially affect blood pressure levels. Monitoring blood pressure before giving sertraline helps ensure patient safety and allows for appropriate interventions if any significant changes are noted. Heart rate, respiratory rate, and mood changes are important assessments but are not typically the first priority when administering sertraline. While heart rate and respiratory rate can also be affected by sertraline, blood pressure assessment is a higher priority due to the medication's known effects on blood pressure regulation.

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