Nursing Elites

1. A client is prescribed digoxin for heart failure. Which of the following should the nurse monitor to evaluate the effectiveness of the medication?

• A. Respiratory rate
• B. Blood pressure
• C. Apical pulse
• D. Urine output

Correct answer: C

Rationale: The correct answer is C: Apical pulse. Digoxin's primary effect is to strengthen the force of the heart's contractions and slow the heart rate. Monitoring the apical pulse is crucial in evaluating the effectiveness of digoxin as it helps assess the medication's impact on the heart's function. Option A, respiratory rate, is not directly related to digoxin's mechanism of action and is not the most appropriate parameter to monitor for this medication. Option B, blood pressure, while important, may not be as sensitive as the apical pulse in assessing the effectiveness of digoxin. Option D, urine output, is more indicative of kidney function and fluid balance, rather than the direct effectiveness of digoxin in heart failure.

2. A nurse is reviewing the ABG results of a client with chronic emphysema. Which result suggests the need for further treatment?

• A. PaO2 level of 89 mm Hg
• B. PaCO2 level of 55 mm Hg
• C. HCO3 level of 25 mEq/L
• D. pH level of 7.37

Correct answer: B

Rationale: The correct answer is B. A PaCO2 level of 55 mm Hg is elevated, indicating carbon dioxide retention, a common complication of emphysema that necessitates intervention. Elevated PaCO2 can lead to respiratory acidosis, reflecting inadequate ventilation. Choices A, C, and D are within normal ranges. A PaO2 level of 89 mm Hg is acceptable. An HCO3 level of 25 mEq/L falls within the normal range, suggesting adequate compensation. A pH level of 7.37 is also within the normal range, indicating the client's acid-base balance is maintained.

3. A nurse is caring for the mother of an adolescent who was killed in a motor-vehicle crash after a school event. The mother states, 'I never should have let him take the car. It's all my fault!' Which of the following responses by the nurse is appropriate?

• A. You had no way of knowing this would happen.
• B. Most parents blame themselves when losing a child.
• C. Tell me why you feel this is your fault.
• D. You appear to be feeling overwhelmed.

Correct answer: C

Rationale: Choice C is the most appropriate response because it encourages the mother to express her feelings and explore the reasons behind her guilt. This approach allows the mother to process her emotions effectively and address her grief. Choices A and B do not directly address the mother's feelings of guilt and may not help her work through her emotions. Choice D acknowledges the mother's emotional state but does not delve into the underlying issues causing her guilt and grief.

4. A nurse is assessing a client with chronic kidney disease. Which of the following should the nurse monitor for?

• A. Hyperkalemia
• B. Hypercalcemia
• C. Hypoglycemia
• D. Hyponatremia

Correct answer: A

Rationale: The correct answer is A: Hyperkalemia. Clients with chronic kidney disease are at risk for hyperkalemia due to impaired potassium excretion. In chronic kidney disease, the kidneys are unable to effectively excrete potassium, leading to its accumulation in the blood. Hypercalcemia (Choice B) is not typically associated with chronic kidney disease. Hypoglycemia (Choice C) refers to low blood sugar levels and is not directly related to chronic kidney disease. Hyponatremia (Choice D) is a condition characterized by low sodium levels and is not a typical concern in chronic kidney disease.

5. A client who is being admitted for induction of labor is receiving teaching about newborn safety from a nurse. Which of the following client statements indicates an understanding of the teaching?

• A. I will check the identification badge of anyone who removes my baby from our room.
• B. I should include a photo of my baby along with any public birth announcements on social media.
• C. I will allow my baby to sleep on the bed in my room when I am in the shower.
• D. I should expect the nurses to carry my baby in their arms to the nursery.

Correct answer: A

Rationale: Choice A is the correct answer because the client should verify the identification badge of anyone removing their baby to ensure the infant's safety and prevent abduction. This statement demonstrates an understanding of the importance of strict identification protocols in the hospital setting. Choice B is incorrect because including a photo of the baby in public announcements does not relate to newborn safety teaching. Choice C is incorrect as it is unsafe to allow a baby to sleep on the bed unsupervised. Choice D is incorrect because nurses typically encourage parents to carry their baby to the nursery themselves for bonding and security reasons.

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