Nursing Elites

1. A nurse is assessing a client with chronic kidney disease. Which laboratory value would indicate the need for hemodialysis?

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

Correct answer: A

Rationale: A GFR of 14 mL/min indicates significant kidney damage and a severe decrease in kidney function. This level of GFR typically indicates the need for hemodialysis to help the kidneys perform their function adequately. BUN, serum magnesium, and serum phosphorus levels are important in assessing kidney function and managing chronic kidney disease but do not specifically indicate the need for hemodialysis. Therefore, choices B, C, and D are incorrect.

2. When admitting a client with fever, confusion, and decreased level of consciousness, what should the nurse do first after obtaining the client's history and assessment?

• A. Identify the client's needs
• B. Start intravenous fluids
• C. Notify the provider
• D. Conduct a neurological assessment

Correct answer: A

Rationale: When a client presents with fever, confusion, and decreased level of consciousness, the first step should be to identify the client's needs. This involves recognizing any immediate concerns or issues that require urgent attention. Starting intravenous fluids, notifying the provider, or conducting a neurological assessment may be necessary actions but should come after identifying the client's needs to ensure proper prioritization of care.

3. A healthcare professional is reviewing the health history of an older adult who has a hip fracture. What is a risk factor for developing pressure injuries?

• A. Dehydration
• B. Urinary incontinence
• C. Poor nutrition
• D. Poor tissue perfusion

Correct answer: B

Rationale: Urinary incontinence is a risk factor for developing pressure injuries due to prolonged skin exposure to moisture and irritants. Dehydration (choice A) can contribute to skin dryness but is not a direct risk factor for pressure injuries. Poor nutrition (choice C) can affect wound healing but is not specifically linked to pressure injuries. Poor tissue perfusion (choice D) can increase the risk of tissue damage but is not as directly associated with pressure injuries as urinary incontinence.

4. A nurse is assessing a client who is at 31 weeks of gestation. Which of the following findings should the nurse identify as an indication of a potential prenatal complication?

• A. Periodic tingling of fingers
• B. Absence of clonus
• C. Leg cramps
• D. Blurred vision

Correct answer: D

Rationale: Blurred vision can be an indicator of serious conditions such as preeclampsia, which involves hypertension and can lead to significant maternal and fetal complications. Periodic tingling of fingers, absence of clonus, and leg cramps are common discomforts during pregnancy but are not typically associated with serious prenatal complications like preeclampsia. Therefore, the correct answer is D.

5. A healthcare provider is caring for a client with severe preeclampsia. Which of the following medications should the healthcare provider anticipate administering?

• A. Magnesium sulfate
• B. Oxytocin
• C. Misoprostol
• D. Nifedipine

Correct answer: A

Rationale: Magnesium sulfate is the correct answer as it is administered to prevent seizures in clients with severe preeclampsia. It acts as a central nervous system depressant and is the first-line treatment for eclampsia prevention. Oxytocin (Choice B) is used to induce or augment labor, not indicated specifically for preeclampsia. Misoprostol (Choice C) is used for labor induction and postpartum hemorrhage, not typically indicated for preeclampsia. Nifedipine (Choice D) is a calcium channel blocker used for managing hypertension in pregnancy but is not the first-line treatment for preventing seizures in severe preeclampsia.

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