Nursing Elites

1. A charge nurse is teaching a new nurse how to clean surfaces contaminated with blood. Which agent should the charge nurse include in the teaching?

• A. Hydrogen peroxide
• B. Chlorhexidine
• C. Isopropyl alcohol
• D. Chlorine bleach

Correct answer: D

Rationale: Chlorine bleach is the most appropriate agent for disinfecting surfaces contaminated with blood. It is effective in killing a wide range of pathogens, including viruses. Hydrogen peroxide (Choice A) is not as effective as chlorine bleach for bloodborne pathogen disinfection. Chlorhexidine (Choice B) and isopropyl alcohol (Choice C) are more commonly used for skin antisepsis rather than surface disinfection, making them less suitable options in this scenario.

2. A client has a new prescription for levothyroxine. What should the nurse teach the client?

• A. It should be taken at night
• B. Monitor for symptoms of hypothyroidism
• C. Take it with calcium supplements
• D. Take it on an empty stomach

Correct answer: D

Rationale: The correct answer is to take levothyroxine on an empty stomach. This is because levothyroxine should be taken in the morning on an empty stomach to ensure proper absorption. Option A is incorrect because levothyroxine is usually advised to be taken in the morning. Option B is not the priority teaching point as monitoring for hypothyroidism symptoms is ongoing care. Option C is incorrect as levothyroxine should not be taken with calcium supplements as they can interfere with its absorption.

3. A nurse is caring for a client with a sealed radiation implant. Which action should the nurse take?

• A. Remove dirty linens after double-bagging
• B. Wear a dosimeter badge
• C. Limit visitors to 1 hour per day
• D. Ensure family remains 3 feet away from the client

Correct answer: B

Rationale: The correct answer is B: Wear a dosimeter badge. When caring for a client with a sealed radiation implant, the nurse should wear a dosimeter badge to monitor radiation exposure. This badge helps measure the amount of radiation the nurse is exposed to during care. Choice A is incorrect because removing dirty linens after double-bagging is not directly related to managing radiation exposure. Choice C is incorrect as there is no specific time limit on visitors mentioned in the context of a sealed radiation implant. Choice D is incorrect as there is no evidence supporting the need for family members to stay a specific distance away from the client.

4. A nurse is assessing a client with chronic kidney disease. Which laboratory value would indicate the need for hemodialysis?

• A. Glomerular filtration rate (GFR) of 14 mL/min
• B. BUN 16 mg/dL
• C. Serum magnesium 1.8 mg/dL
• D. Serum phosphorus 4.0 mg/dL

Correct answer: A

Rationale: A GFR of 14 mL/min indicates significant kidney damage and a severe decrease in kidney function. This level of GFR typically indicates the need for hemodialysis to help the kidneys perform their function adequately. BUN, serum magnesium, and serum phosphorus levels are important in assessing kidney function and managing chronic kidney disease but do not specifically indicate the need for hemodialysis. Therefore, choices B, C, and D are incorrect.

5. 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.

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