Nursing Elites

1. A nurse caring for a group of clients reviews the electrolyte laboratory results and notes a sodium level of 130 mEq/L on one client's laboratory report. The nurse understands that which client is at highest risk for the development of a sodium value at this level?

• A. The client with renal failure
• B. The client who is taking diuretics
• C. The client with hyperaldosteronism
• D. The client who is taking corticosteroids

Correct answer: B

Rationale: The correct answer is B. Clients taking diuretics are at risk for hyponatremia due to excessive sodium loss. In this scenario, a sodium level of 130 mEq/L indicates hyponatremia, which is commonly associated with diuretic use. Options A, C, and D are not the highest risk factors for developing low sodium levels in this context. Renal failure, hyperaldosteronism, and corticosteroid use are not directly linked to sodium loss as seen with diuretics.

2. A nurse is receiving a verbal prescription from the provider for a client who is experiencing increased pain. The nurse should transcribe which of the following prescriptions in the client's medical record?

• A. Morphine sulfate 10 mg IV q 4 IV prn for pain
• B. MS 10 mg IV every 4 8 prn for pain
• C. MSO4 10 mg IVP q 4 8 prn for pain
• D. Morphine sulfate 10.0 mg every 4 hours IV prn for pain

Correct answer: A

Rationale: The correct transcription is 'Morphine sulfate 10 mg IV q 4 IV prn for pain.' In choice A, 'Morphine sulfate 10 mg IV q 4 IV prn for pain' correctly indicates the medication, route (IV), frequency (every 4 hours), and administration as needed for pain control. Choice B is incorrect as 'MS' is not a standard abbreviation for Morphine Sulfate, and the frequency 'every 4 8' is not a valid time interval. Choice C is incorrect as 'MSO4' is not the standard abbreviation for Morphine Sulfate, and 'IVP' is not the standard route abbreviation for intravenous. Choice D is incorrect as it lacks clarity with '10.0 mg' instead of '10 mg,' and the frequency is given as 'every 4 hours' without specifying the route of administration.

3. A nurse on a med-surg unit is caring for a group of clients with the assistance of an LPN and an AP. Which of the following tasks should the nurse assign to the LPN?

• A. Reinforce dietary teaching with a client who has heart disease.
• B. Obtaining a urine specimen from an older adult client
• C. Providing postmortem care for a client who has just died.
• D. Accompanying a client who just had a wound debridement to PT.

Correct answer: A

Rationale: The correct answer is to reinforce dietary teaching with a client who has heart disease. This task falls within the LPN's scope of practice as they can provide education and support related to nutrition. Obtaining a urine specimen (Choice B) is typically performed by nursing assistants. Providing postmortem care (Choice C) is a sensitive task usually performed by registered nurses. Accompanying a client to physical therapy (Choice D) is often done by nursing assistants or other supportive staff.

4. Which manifestation should the nurse expect to assess in a patient with fluid volume deficit?

• A. Headache and muscle cramps
• B. Dyspnea and respiratory crackles
• C. Increased pulse rate and blood pressure
• D. Orthostatic hypotension and flat neck veins

Correct answer: D

Rationale: Orthostatic hypotension and flat neck veins are classic manifestations of fluid volume deficit. When the body loses fluid, blood volume decreases, leading to decreased venous return to the heart, resulting in orthostatic hypotension and flat neck veins. Choices A, B, and C are more indicative of other conditions such as dehydration, respiratory issues, or compensatory mechanisms in response to hypovolemia, respectively.

5. Your patient has been diagnosed with giant cell arthritis. What medication will this patient most likely be given?

• A. High doses of aspirin
• B. High doses of prednisone
• C. Methotrexate
• D. Albuterol

Correct answer: B

Rationale: High doses of prednisone are commonly prescribed for giant cell arthritis to reduce inflammation. Aspirin is not typically used for this condition. Methotrexate is more commonly used for conditions like rheumatoid arthritis, not giant cell arthritis. Albuterol is a bronchodilator used for respiratory conditions, not for giant cell arthritis.

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