Nursing Elites

1. A nurse is assessing a client who is 1 hour postoperative following a hysterectomy. Which of the following findings should the nurse report to the provider?

• A. Heart rate of 78/min.
• B. Blood pressure of 120/80 mm Hg.
• C. Oxygen saturation of 94%.
• D. Respiratory rate of 16/min.

Correct answer: A

Rationale: A heart rate of 78/min is within the normal range; however, postoperative patients require close monitoring for any signs of complications. While the heart rate is normal, other critical findings such as increased pain, excessive bleeding, or other concerning symptoms may need immediate attention. Choices B, C, and D all indicate normal postoperative vital signs and oxygen saturation levels, which do not raise immediate concerns requiring reporting to the provider.

2. What is the primary action when a healthcare provider discovers a patient has fallen?

• A. Assess the patient for injuries
• B. Call for help immediately
• C. Document the fall
• D. Notify the healthcare provider

Correct answer: A

Rationale: When a healthcare provider discovers a patient has fallen, the primary action should be to assess the patient for injuries. This is crucial to determine the extent of harm and if immediate treatment is necessary. Calling for help is important, but assessing the patient's condition takes precedence to ensure the patient's safety and well-being. While documenting the fall and notifying the healthcare provider are essential steps, they come after assessing the patient's injuries.

3. How should a healthcare provider manage a patient with chronic pain?

• A. Administer analgesics
• B. Encourage physical activity
• C. Administer non-pharmacological interventions
• D. Encourage deep breathing exercises

Correct answer: A

Rationale: Administering prescribed analgesics is a crucial aspect of managing chronic pain effectively. Analgesics help alleviate pain symptoms and improve the patient's quality of life. While physical activity and non-pharmacological interventions can also play a role in pain management, the immediate need for relief in chronic pain often requires pharmacological intervention. Encouraging deep breathing exercises may provide some relief in certain situations, but it may not be as effective as analgesics for managing chronic pain.

4. A nurse is caring for a client who is receiving enteral feedings through a nasogastric tube. Which of the following findings should the nurse report to the provider?

• A. Gastric residual of 200 mL or more
• B. pH of gastric contents is 5.0
• C. Bowel sounds are present in all quadrants
• D. Temperature 37.5°C (99.5°F)

Correct answer: A

Rationale: The correct answer is A. A gastric residual of 200 mL or more indicates delayed gastric emptying, which can be a sign of potential complications such as aspiration or intolerance to the enteral feedings. This finding should be reported to the healthcare provider for further evaluation and possible intervention. Choices B, C, and D are within normal limits and do not require immediate reporting. A pH of 5.0 is normal for gastric contents, bowel sounds in all quadrants indicate normal gastrointestinal motility, and a temperature of 37.5°C (99.5°F) is within the normal range.

5. A nurse in an emergency department is caring for a client who reports cocaine use 1hr ago. Which of the following findings should the nurse expect?

• A. Hypotension
• B. Memory loss
• C. Slurred speech
• D. Elevated temperature

Correct answer: D

Rationale: The correct answer is D: Elevated temperature. Cocaine is a stimulant drug that can lead to an increase in body temperature. Hypotension (choice A) is less likely as cocaine tends to increase blood pressure. Memory loss (choice B) and slurred speech (choice C) are not typically immediate effects of recent cocaine use.

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