Nursing Elites

1. Which problem in a client requires the most immediate intervention by the nurse?

• A. Finger paresthesias related to carpal tunnel syndrome.
• B. Increasing sharp pain related to compartment syndrome.
• C. Increasing burning pain related to a Morton's neuroma.
• D. Increasing sharp pain related to plantar fasciitis.

Correct answer: B

Rationale: The correct answer is B: Increasing sharp pain related to compartment syndrome. Compartment syndrome is a serious condition where increased pressure within a muscle compartment compromises circulation and can lead to tissue damage. Immediate intervention is crucial to prevent permanent damage to muscles and nerves, including tissue necrosis and nerve injury. Choices A, C, and D do not present the same level of urgency as compartment syndrome, making them less critical for immediate intervention. Carpal tunnel syndrome, Morton's neuroma, and plantar fasciitis may cause discomfort and functional limitations but are not typically considered emergencies requiring urgent intervention like compartment syndrome.

2. A client with cirrhosis of the liver is experiencing pruritus. Which intervention should the nurse implement to help relieve the client's symptoms?

• A. Administer acetaminophen (Tylenol).
• B. Apply lotion to the skin.
• C. Encourage a high-protein diet.
• D. Provide a warm bath.

Correct answer: B

Rationale: Pruritus is a common symptom in clients with cirrhosis due to bile salts accumulating in the skin. Applying lotion to the skin helps soothe the itching and can prevent skin breakdown. Acetaminophen can worsen liver damage in clients with cirrhosis as it is metabolized in the liver. Encouraging a high-protein diet is not directly related to relieving pruritus. Providing a warm bath may further dry the skin, exacerbating the itching. Therefore, the most appropriate intervention to help relieve pruritus in a client with cirrhosis is to apply lotion to the skin.

3. The charge nurse observes that a client with a nasogastric tube on low intermittent suction is drinking a glass of water immediately after the unlicensed assistive personnel (UAP) left the room. What action should the nurse take?

• A. Remove the glass of water and speak to the UAP.
• B. Discuss the incident with the UAP at the end of the day.
• C. Write an incident report and notify the healthcare provider.
• D. Remind the client of the potential for electrolyte imbalance.

Correct answer: A

Rationale: The correct action for the charge nurse to take is to remove the glass of water and speak to the UAP. This ensures immediate correction and education to prevent further issues with the nasogastric tube. Addressing the situation promptly can prevent harm to the client and reinforces the importance of following proper protocols.

4. In a patient with chronic kidney disease (CKD) receiving erythropoietin therapy, what laboratory result should the nurse monitor to evaluate the effectiveness of this therapy?

• A. Serum creatinine
• B. White blood cell count
• C. Hemoglobin level
• D. Serum potassium

Correct answer: C

Rationale: The correct answer is C: Hemoglobin level. Erythropoietin therapy is used to stimulate red blood cell production in patients with chronic kidney disease who often develop anemia due to reduced erythropoietin production by the kidneys. Monitoring the hemoglobin level is essential to evaluate the effectiveness of erythropoietin therapy as an increase in hemoglobin indicates improved red blood cell production and better management of anemia in these patients. Serum creatinine, white blood cell count, and serum potassium levels are important parameters to monitor in CKD patients but are not specific indicators of the effectiveness of erythropoietin therapy for managing anemia.

5. A client with chronic renal failure is scheduled to receive epoetin alfa (Epogen). Which laboratory result should the nurse review before administering the medication?

• A. Blood urea nitrogen (BUN)
• B. Creatinine clearance
• C. Hemoglobin level
• D. Serum potassium

Correct answer: C

Rationale: The correct answer is to review the hemoglobin level before administering epoetin alfa (Epogen) to assess its effectiveness in stimulating red blood cell production. Hemoglobin level is a crucial indicator to monitor in clients with chronic renal failure receiving this medication. Choice A (Blood urea nitrogen) and Choice B (Creatinine clearance) are commonly monitored in renal failure but are not specifically relevant to assessing the effectiveness of epoetin alfa. Choice D (Serum potassium) is important to monitor due to potential imbalances in renal failure, but it is not directly related to evaluating the effectiveness of epoetin alfa.

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