Nursing Elites

1. A healthcare provider is assessing a client with a diagnosis of acute pancreatitis. Which laboratory value would be most concerning?

• A. Serum amylase of 200 U/L
• B. Serum lipase of 250 U/L
• C. Blood glucose of 200 mg/dL
• D. Serum calcium of 7.5 mg/dL

Correct answer: D

Rationale: In acute pancreatitis, hypocalcemia (low serum calcium) is a critical finding that is associated with a poor prognosis and requires immediate attention. Serum amylase and lipase are typically elevated in acute pancreatitis due to pancreatic inflammation, but they are not indicators of severity. Blood glucose levels may be elevated due to stress or underlying conditions but are not directly related to the severity of acute pancreatitis. Therefore, the most concerning value in this scenario is the low serum calcium level, which can have significant implications for the client's prognosis.

2. The nurse is caring for an older adult patient with a diagnosis of urinary tract infection (UTI). Upon assessment, the nurse finds the patient confused and agitated. How will the nurse interpret these assessment findings?

• A. These are normal signs of aging.
• B. These are early signs of dementia.
• C. These are purely psychological in origin.
• D. These are common manifestations with UTIs.

Correct answer: D

Rationale: The nurse should interpret confusion and agitation in an older adult patient with a UTI as common manifestations of the infection. In older patients, confusion is a primary symptom of a compromised state due to an acute urinary tract infection or fever. Choice A is incorrect as confusion and agitation are not normal signs of aging. Choice B is incorrect because these symptoms are more likely related to the UTI rather than early signs of dementia. Choice C is incorrect as confusion and agitation in this context are not purely psychological but are likely physiological responses to the UTI.

3. A nurse is planning an education session for an older adult client who has just learned that she has type 2 diabetes mellitus. Which of the following strategies should the nurse plan to use with this client?

• A. Allow extra time for the client to respond to questions
• B. Expect the client to have difficulty understanding the information
• C. Avoid references to the client’s past experiences
• D. Keep the learning session private and one-on-one

Correct answer: A

Rationale: Corrected Choice A, allowing extra time for the client to respond to questions, is the appropriate strategy when educating an older adult with type 2 diabetes mellitus. Older adults may need additional time to process information and formulate responses. Choice B is incorrect as it assumes the client will have difficulty understanding the information, which may not be the case. Choice C is incorrect because referencing the client's past experiences can help personalize the education session. Choice D is also incorrect as keeping the learning session private and one-on-one may not be necessary for all clients and may limit the potential benefits of group education and support.

4. A client with a terminal illness is being educated by a healthcare provider about declining resuscitation in a living will. The client asks, “What would happen if I arrived at the ED and I had difficulty breathing?”

• A. We would give you oxygen through a tube in your nose.
• B. We would initiate full resuscitation efforts.
• C. We would consult the living will and provide comfort care.
• D. We would not provide any medical intervention.

Correct answer: C

Rationale: In the scenario described, the client has a living will that declines resuscitation. Therefore, if the client arrives at the emergency department with difficulty breathing, healthcare providers would consult the living will to understand the client's wishes. Providing comfort care, which may include oxygen therapy to alleviate symptoms, aligns with the client's preferences. Option A incorrectly suggests an intervention that goes against the client's wishes. Option B is incorrect because full resuscitation efforts are not in line with the client's choice to decline resuscitation. Option D is also incorrect as it does not consider the client's living will and the need to provide care according to the documented preferences of the client.

5. During an integumentary assessment for a group of clients, a healthcare professional notes various skin findings. Which of the following findings should the professional recognize as requiring immediate intervention?

• A. Pallor
• B. Cyanosis
• C. Jaundice
• D. Erythema

Correct answer: B

Rationale: Cyanosis, a bluish discoloration of the skin, indicates inadequate oxygenation and requires immediate intervention. It suggests a severe lack of oxygen in the blood, which can be life-threatening. Pallor and jaundice are concerning findings but may not indicate an immediate life-threatening situation. Pallor can be a sign of anemia or low blood pressure, while jaundice may indicate liver dysfunction. Erythema, which is redness of the skin, is typically not an emergency and can be caused by various factors such as inflammation or increased blood flow to the area.

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