Nursing Elites

1. A nurse is assigned to care for four clients. Which client should the nurse assess first?

• A. A client with chest pain and shortness of breath
• B. A client with a fever of 100°F
• C. A client scheduled for surgery
• D. A client with stable vital signs

Correct answer: A

Rationale: The correct answer is A. Chest pain and shortness of breath are symptoms that could indicate a life-threatening condition such as a heart attack or pulmonary embolism. Therefore, this client should be assessed first to ensure prompt intervention and treatment. Choice B, a client with a fever of 100°F, may indicate an infection but is not immediately life-threatening compared to the symptoms of chest pain and shortness of breath. Choice C, a client scheduled for surgery, is not an immediate priority unless there are specific preoperative assessments or interventions required. Choice D, a client with stable vital signs, does not indicate an urgent need for assessment compared to the client with chest pain and shortness of breath.

2. A healthcare provider is providing a report to a colleague about a client who weighs 210 lb and has a prescription for one-third weight bearing on the right leg. How many kg of weight should the client bear on the right leg?

• A. 32 kg
• B. 35 kg
• C. 40 kg
• D. 45 kg

Correct answer: A

Rationale: To calculate the weight-bearing limit, we first need to convert 210 lbs to kg. To do this, we use the conversion factor 1 lb = 0.453592 kg. So, 210 lbs is equal to 210 * 0.453592 = 95.254 kg. One-third of 95.254 kg is 31.7513 kg, which can be rounded to 32 kg. Therefore, the client should bear 32 kg of weight on the right leg. Choice A is the correct answer. Choices B, C, and D are incorrect as they do not reflect the accurate calculation based on the client's weight and the prescribed weight-bearing limit.

3. The family member is observing a family member changing a dressing for a patient in the home health environment. Which observation indicates the family member has a correct understanding of how to manage contaminated dressings?

• A. The family member saves part of the dressing because it is clean.
• B. The family member places the used dressings in a plastic bag.
• C. The family member removes gloves and gathers items for disposal.
• D. The family member wraps the used dressing in toilet tissue before placing it in the trash.

Correct answer: B

Rationale: The correct way to manage contaminated dressings is to place them in plastic bags for proper disposal. This helps prevent the spread of infection. Choice A is incorrect because saving part of the dressing is not a recommended practice. Choice C is not directly related to managing contaminated dressings. Choice D is incorrect as wrapping the used dressing in toilet tissue is not the appropriate way to dispose of contaminated dressings.

4. A healthcare provider is assessing a patient with chronic pain. Which finding is most concerning?

• A. The patient reports a pain level of 6 on a scale of 0 to 10.
• B. The patient is lying still and refuses to move.
• C. The patient's pain persists despite medication.
• D. The patient reports feeling anxious and restless.

Correct answer: C

Rationale: In the context of chronic pain management, the most concerning finding is when the patient's pain persists despite medication. This suggests inadequate pain control or the need for a re-evaluation of the treatment plan. Choices A, B, and D are not as concerning in this scenario. A pain level of 6 on a scale of 0 to 10 is moderate and may be manageable with appropriate interventions. Patients with chronic pain can sometimes lie still due to pain or other reasons, and anxiety and restlessness are common in individuals with pain conditions but may not necessarily indicate a critical issue like uncontrolled pain.

5. A healthcare provider is reviewing the medical record of a client who has a new prescription for clozapine. Which of the following findings indicates a contraindication to clozapine?

• A. Fasting blood glucose of 120 mg/dL
• B. Asthma
• C. Hypertension
• D. WBC count of 3,300/mm3

Correct answer: D

Rationale: A low WBC count (3,300/mm3) is a contraindication to clozapine because this medication can cause severe neutropenia. Neutropenia is a significant reduction in white blood cell count, increasing the risk of infections. Elevated fasting blood glucose, asthma, and hypertension are not direct contraindications to clozapine.

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