Nursing Elites

1. A client has received 2 units of whole blood today following an episode of GI bleeding. Which of the following laboratory reports would the nurse monitor most closely?

• A. Bleeding time
• B. Hemoglobin and hematocrit
• C. White blood cells
• D. Platelets

Correct answer: B

Rationale: Corrected Hemoglobin and hematocrit levels should be monitored closely after blood transfusions to assess the effectiveness and identify any complications. Monitoring hemoglobin and hematocrit levels helps evaluate the patient's oxygen-carrying capacity and blood volume. While platelets are crucial for clotting, they are not typically affected immediately after a blood transfusion. White blood cell count monitoring is more relevant in assessing infection or immune response, not directly related to a blood transfusion. Bleeding time measures platelet function, which is not the primary concern immediately after a blood transfusion.

2. When reassigned to the emergency department, a nurse should understand that gastric lavage is a priority in which situation?

• A. An infant who has been identified to have botulism
• B. A toddler who ate a number of ibuprofen tablets
• C. A preschooler who swallowed powdered plant food
• D. A school-aged child who took a handful of vitamins

Correct answer: A

Rationale: The correct answer is A because gastric lavage is a priority for infants with botulism to remove toxins from the stomach. Botulism is a serious condition caused by a toxin produced by Clostridium botulinum bacteria. Gastric lavage helps in removing the toxin from the stomach. Choice B is incorrect because gastric lavage is not typically indicated for ibuprofen ingestion. Choice C is incorrect because gastric lavage is not the first-line treatment for ingesting powdered plant food. Choice D is incorrect because gastric lavage is not routinely performed for vitamin ingestion.

3. The nurse is assessing a client 2 hours postoperatively after a femoral popliteal bypass. The upper leg dressing becomes saturated with blood. The nurse's first action should be to

• A. Wrap the leg with elastic bandages
• B. Apply pressure at the bleeding site
• C. Reinforce the dressing and elevate the leg
• D. Remove the dressings and re-dress the incision

Correct answer: B

Rationale: In this scenario where the upper leg dressing becomes saturated with blood post-femoral popliteal bypass, the nurse's first action should be to apply pressure at the bleeding site. Applying pressure is essential to control hemorrhage and prevent further blood loss. Choice A is incorrect as wrapping the leg with elastic bandages would not address the immediate issue of controlling the bleeding. Choice C is incorrect because reinforcing the dressing and elevating the leg should come after controlling the bleeding. Choice D is incorrect as removing the dressings and re-dressing the incision should only be done after the bleeding is under control to prevent excessive blood loss.

4. A healthcare professional is assisting with the development of an education program about nutritional risk among adolescents to a group of parents of adolescents. Which of the following information should the healthcare professional include in the teaching? (Select all that apply).

• A. Skipping more than three meals per week
• B. Eating fast food once a week
• C. Hearty appetite
• D. Drink whole milk to ensure adequate calcium intake.

Correct answer: A

Rationale: Skipping more than three meals per week is an indicator of poor nutritional habits in adolescents. This can lead to inadequate nutrient intake and negatively impact growth and development. Choices B, C, and D are not directly associated with poor nutritional habits among adolescents. Eating fast food once a week may not necessarily indicate poor nutrition if the overall diet is balanced. Having a hearty appetite does not provide specific information about nutritional risk, as appetite can vary among individuals. While whole milk can be a source of calcium, it is not necessary to drink whole milk specifically to ensure adequate calcium intake, as there are other sources of calcium available.

5. For a client with chronic kidney disease having a hemoglobin level of 8.0 g/dL, which intervention should the nurse perform first?

• A. Administer erythropoietin as ordered
• B. Monitor the client's blood pressure
• C. Monitor the client's oxygen saturation level
• D. Assess the client for signs of fatigue

Correct answer: A

Rationale: Administering erythropoietin is the priority intervention for a client with chronic kidney disease and a low hemoglobin level. Erythropoietin stimulates red blood cell production, helping to manage anemia in these clients. Monitoring blood pressure, oxygen saturation level, and assessing for signs of fatigue are important aspects of care but addressing the anemia by administering erythropoietin takes precedence to improve oxygen-carrying capacity and overall well-being.

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