Nursing Elites

1. A client with a history of peptic ulcer disease is admitted with abdominal pain. Which finding should the LPN/LVN report to the healthcare provider immediately?

• A. Positive bowel sounds
• B. Rebound tenderness
• C. Increased appetite
• D. Elevated temperature

Correct answer: D

Rationale: Elevated temperature is the correct finding to report immediately in a client with a history of peptic ulcer disease and abdominal pain. This could indicate a perforation or worsening of the condition, requiring prompt medical attention. Positive bowel sounds (Choice A) are a normal finding and not a cause for concern. Rebound tenderness (Choice B) is concerning but does not require immediate attention compared to an elevated temperature. Increased appetite (Choice C) is not a red flag symptom for peptic ulcer disease and can be considered a positive sign, not requiring immediate attention.

2. A 10-year-old client is recovering from a splenectomy following a traumatic injury. The client's laboratory results show a hemoglobin of 9 g/dL and a hematocrit of 28 percent. The best approach for the nurse to use is to:

• A. Limit milk and milk products
• B. Encourage bed rest and quiet activities
• C. Plan nursing care around lengthy rest periods
• D. Promote a diet rich in iron

Correct answer: C

Rationale: Encouraging bed rest and quiet activities is crucial for a child recovering from a splenectomy with low hemoglobin and hematocrit levels. This approach helps conserve energy, promotes healing, and allows the body to focus on rebuilding red blood cells. Limiting milk and milk products (Choice A) is not directly related to improving the child's condition. Encouraging bed rest and quiet activities (Choice B) is appropriate as it helps in conserving energy and preventing physical exertion. Promoting a diet rich in iron (Choice D) is beneficial for improving hemoglobin levels in the long term, but immediate rest and recovery take precedence in this scenario.

3. A healthcare professional is planning weight loss strategies for a group of clients who are obese. Which of the following actions by the professional will improve the clients' commitment to a long-term goal of weight loss?

• A. Help the clients increase their self-motivation
• B. Recommend gradual dietary changes tailored to the clients' preferences
• C. Emphasize the importance of both exercise and dietary changes
• D. Encourage setting both short-term and long-term goals

Correct answer: A

Rationale: Helping the clients increase their self-motivation is crucial for long-term weight loss success. By empowering clients to find their internal drive to make healthy choices, they are more likely to stay committed to their goals. Choice B is incorrect because recommending a strict diet plan immediately may not consider the clients' individual preferences and needs, leading to potential disengagement. Choice C is incorrect as focusing solely on exercise without addressing dietary changes does not provide a comprehensive approach to weight loss. Choice D is incorrect because setting only short-term goals may not foster sustained progress towards achieving a healthier weight.

4. The healthcare provider attaches a pulse oximeter to a client's fingers and obtains an oxygen saturation reading of 91%. Which assessment finding most likely contributes to this reading?

• A. BP 142/88 mmHg
• B. 2+ edema of fingers and hands
• C. Radial pulse volume is +3
• D. Capillary refill time is 2 seconds

Correct answer: B

Rationale: Edema, indicated by 2+ edema of fingers and hands, can impair blood flow and peripheral perfusion, leading to reduced oxygen saturation readings on a pulse oximeter. High blood pressure (choice A) would not directly affect oxygen saturation readings. Radial pulse volume (choice C) and capillary refill time (choice D) are more related to assessing circulation rather than contributing significantly to oxygen saturation readings.

5. The healthcare professional is caring for a client with a chest tube. What is the most important action for the healthcare professional to take to ensure the chest tube is functioning properly?

• A. Milk the chest tube to ensure patency.
• B. Clamp the chest tube when moving the client.
• C. Ensure the water seal chamber is filled to the appropriate level.
• D. Secure the chest tube to the client's bed.

Correct answer: C

Rationale: Ensuring the water seal chamber is filled to the appropriate level is crucial to maintain the effectiveness of the chest tube drainage system. This step helps prevent air from entering the pleural space, ensuring proper lung re-expansion. 'Milking' the chest tube is not recommended as it can cause damage to the chest tube and surrounding tissues. Clamping the chest tube is not advisable as it can lead to tension pneumothorax. Securing the chest tube to the bed is important for stability but does not directly impact the functioning of the chest tube.

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