Nursing Elites

1. A healthcare professional is assessing a client who has chronic kidney disease. Which of the following findings is an indication for hemodialysis?

• A. BUN 16 mg/dL
• B. Serum magnesium 1.8 mg/dL
• C. Serum phosphorus 4.0 mg/dL
• D. Glomerular filtration rate of 14 mL/min

Correct answer: D

Rationale: A glomerular filtration rate of 14 mL/min indicates severe kidney impairment and the need for hemodialysis. The other choices, such as BUN 16 mg/dL, serum magnesium 1.8 mg/dL, and serum phosphorus 4.0 mg/dL, are within normal ranges and do not directly indicate the need for hemodialysis in chronic kidney disease.

2. A client who has a new prescription for prednisone is being taught by a nurse. Which of the following statements by the client indicates an understanding of the teaching?

• A. I will avoid taking this medication with food.
• B. I will need to take this medication for the rest of my life.
• C. I will take this medication for 2 weeks and then stop.
• D. I will take this medication with a high-protein snack.

Correct answer: B

Rationale: The correct answer is B because prednisone is usually prescribed for long-term use. Stopping it abruptly can lead to adrenal insufficiency. Choice A is incorrect because prednisone should be taken with food to prevent stomach upset. Choice C is incorrect as prednisone is typically tapered off gradually to avoid adverse effects. Choice D is incorrect as there is no specific requirement to take prednisone with a high-protein snack.

3. A nurse is preparing to administer an intermittent enteral feeding to a client who has a gastrostomy tube. Which of the following actions should the nurse take?

• A. Flush the tube with 30 mL of water after feeding
• B. Flush the tube with 10 mL of sterile water before feeding
• C. Place the client in a left lateral position
• D. Place the feeding bag 61 cm (24 in) above the client's abdomen

Correct answer: B

Rationale: Administering an intermittent enteral feeding through a gastrostomy tube requires flushing the tube with 10 mL of sterile water before feeding. This action helps ensure patency and prevents clogging. Choice A is incorrect because flushing after feeding does not address the need for pre-feeding tube flushing. Choice C is unrelated to tube feeding administration. Choice D is incorrect as the height of the feeding bag above the abdomen is typically regulated by healthcare facility policies and is not a universal standard.

4. A healthcare provider is assessing a client who has bacterial meningitis. Which of the following findings should the healthcare provider expect?

• A. Nuchal rigidity.
• B. Flaccid paralysis.
• C. Bradycardia.
• D. Hypothermia.

Correct answer: A

Rationale: Nuchal rigidity is a classic sign of bacterial meningitis and indicates inflammation of the meninges. It is characterized by neck stiffness and pain upon neck flexion. Flaccid paralysis (Choice B) is not typically associated with bacterial meningitis but rather conditions like Guillain-Barre syndrome. Bradycardia (Choice C) and hypothermia (Choice D) are not commonly seen in bacterial meningitis; instead, patients may present with fever, tachycardia, and signs of systemic inflammation.

5. A nurse is caring for a client who has a pulmonary embolism. The nurse should identify the effectiveness of the treatment by assessing which of the following?

• A. A chest x-ray reveals increased density in all lung fields
• B. The client reports feeling less anxious
• C. Diminished breath sounds are auscultated unilaterally
• D. ABG results include pH 7.48, PaO2 77 mm Hg, and PaCO2 47 mm Hg

Correct answer: B

Rationale: The correct answer is B. Client-reported improvement in anxiety is an indication of effective treatment for pulmonary embolism. Choice A is incorrect as increased density in all lung fields on a chest x-ray may indicate complications or lack of improvement. Choice C is incorrect as diminished breath sounds auscultated unilaterally may suggest a localized lung issue and not necessarily reflect the effectiveness of treatment for a pulmonary embolism. Choice D is incorrect as the ABG results provided do not specifically indicate the effectiveness of treatment for a pulmonary embolism.

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