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. What is the appropriate action when a patient presents with chest pain?

• A. Administer aspirin
• B. Administer nitroglycerin
• C. Reposition the patient
• D. Prepare for surgery

Correct answer: A

Rationale: The appropriate action when a patient presents with chest pain is to administer aspirin. Aspirin helps reduce the risk of clot formation by inhibiting platelet aggregation, which can be beneficial in cases of myocardial infarction. Nitroglycerin is commonly used for chest pain related to angina but is not the first-line treatment for all types of chest pain. Repositioning the patient may be necessary for comfort or assessment but is not the immediate priority. Surgery is not typically the first-line intervention for chest pain unless there are specific indications.

3. What is the best way to manage a patient with suspected deep vein thrombosis (DVT)?

• A. Administer anticoagulants
• B. Apply compression stockings
• C. Encourage ambulation
• D. Monitor oxygen saturation

Correct answer: A

Rationale: The correct answer is A: Administer anticoagulants. Administering anticoagulants is crucial in managing patients with suspected DVT as it helps prevent further clot formation and reduces the risk of complications like pulmonary embolism. Choice B, applying compression stockings, is more focused on preventing DVT in high-risk patients rather than managing an established case. Encouraging ambulation, choice C, is beneficial in the prevention of DVT but is not the primary management for suspected cases. Monitoring oxygen saturation, choice D, is important in overall patient care but is not the primary intervention for suspected DVT.

4. A nurse is teaching a client who has hypertension about managing blood pressure. Which of the following statements should the nurse make?

• A. Increase your intake of red meat to manage your blood pressure.
• B. You should avoid drinking alcohol while taking this medication.
• C. Exercise for at least 30 minutes most days of the week.
• D. Limit your fluid intake to 3 liters per day.

Correct answer: C

Rationale: The correct statement is C: 'Exercise for at least 30 minutes most days of the week.' Regular exercise is essential in managing blood pressure as it helps improve cardiovascular health. Choice A is incorrect as increasing red meat intake can be detrimental due to its high saturated fat content, which can negatively impact blood pressure. Choice B is not directly related to managing blood pressure unless the medication interacts negatively with alcohol. Choice D, limiting fluid intake to 3 liters per day, is not a general recommendation for managing blood pressure unless specifically advised by a healthcare provider.

5. A nurse is assessing a client who has a chest tube and notes continuous bubbling in the water seal chamber. Which of the following actions should the nurse take?

• A. Continue to monitor the client.
• B. Clamp the chest tube.
• C. Replace the drainage system.
• D. Apply a dressing over the insertion site.

Correct answer: D

Rationale: The correct action for the nurse to take when continuous bubbling is noted in the water seal chamber of a chest tube is to apply a dressing over the insertion site. Continuous bubbling indicates an air leak, and applying a dressing helps manage this issue by providing a seal. Clamping the chest tube or replacing the drainage system is not appropriate in this situation as it can lead to complications such as tension pneumothorax or inadequate drainage of the pleural space.

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