Nursing Elites

1. A client is admitted with a suspected pulmonary embolism (PE). What is the nurse's priority intervention?

• A. Administer anticoagulant therapy as prescribed.
• B. Elevate the head of the bed to 45 degrees.
• C. Check the client's oxygen saturation.
• D. Prepare the client for a CT scan.

Correct answer: D

Rationale: The correct answer is to prepare the client for a CT scan. A CT scan is essential in confirming the presence of a pulmonary embolism (PE) and guiding further treatment. Administering anticoagulant therapy (Choice A) is important in the management of PE, but it is not the priority intervention in this case. Elevating the head of the bed (Choice B) is beneficial for optimizing oxygenation but is not the priority intervention when a PE is suspected. Checking the client's oxygen saturation (Choice C) is important, but obtaining a definitive diagnosis through a CT scan takes precedence in this situation.

2. A client with atrial fibrillation is prescribed warfarin. What is the most important instruction the nurse should give?

• A. Take the medication with aspirin to improve effectiveness.
• B. Increase intake of green leafy vegetables to support the medication.
• C. Avoid foods high in potassium to reduce bleeding risk.
• D. Avoid alcohol and over-the-counter medications without consulting the provider.

Correct answer: D

Rationale: The correct answer is D. Clients taking warfarin should avoid alcohol and over-the-counter medications without consulting their healthcare provider, as these can interact with warfarin and increase the risk of bleeding. Aspirin, in particular, can exacerbate this risk. Choice A is incorrect because taking warfarin with aspirin can increase the risk of bleeding. Choice B is incorrect as while green leafy vegetables contain vitamin K which can interact with warfarin, it is more important to maintain a consistent intake rather than increase it. Choice C is incorrect because foods high in potassium do not directly impact the bleeding risk associated with warfarin.

3. At 42-weeks gestation, a client refuses induction and desires a natural delivery. What is the most important action for the nurse to take?

• A. Discuss alternative ways to support her birth plan.
• B. Explain the indications for induction in post-term pregnancy.
• C. Discuss the differences between labor with oxytocin and natural labor.
• D. Ask the healthcare provider to discuss the issue with the client.

Correct answer: A

Rationale: The correct answer is to discuss alternative ways to support her birth plan. It is crucial to respect the client's autonomy and desires while ensuring their safety and well-being. Choice B is incorrect because while educating the client about the indications for induction is important, it is not the most immediate action to take in this scenario. Choice C is incorrect as it focuses on comparing labor types rather than supporting the client's birth plan. Choice D is incorrect as the nurse should first engage with the client directly before involving the healthcare provider.

4. A client is receiving IV antibiotic therapy for sepsis. Which assessment finding indicates that the client's condition is improving?

• A. Urine output increases to 25 mL/hour
• B. Client reports feeling less fatigued
• C. Heart rate decreases from 120 to 110 beats per minute
• D. White blood cell count decreases from 15,000 to 9,000/mm3

Correct answer: D

Rationale: The correct answer is D. A decrease in white blood cell count indicates that the infection is responding to treatment, making this the most objective indicator of improvement in a client with sepsis. Choices A, B, and C are subjective indicators and may not always directly correlate with the resolution of the underlying infection. While an increase in urine output, a client reporting feeling less fatigued, and a decrease in heart rate are positive signs, they are not as specific or directly related to the resolution of the infection as a decrease in white blood cell count.

5. A client with dysphagia is having difficulty swallowing medications. What is the nurse's best intervention?

• A. Crush the medications and mix them with applesauce.
• B. Encourage the client to drink water with each dose.
• C. Consult with the healthcare provider about switching to liquid medications.
• D. Offer the client soft foods to reduce difficulty swallowing.

Correct answer: C

Rationale: The best intervention for a client with dysphagia experiencing difficulty swallowing medications is to consult with the healthcare provider about switching to liquid medications. Liquid medications are often easier to swallow and can reduce the risk of choking and aspiration in clients with dysphagia. Crushing medications can alter their effectiveness, encouraging the client to drink water may not be sufficient, and offering soft foods is not directly related to improving medication swallowing.

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