Nursing Elites

1. A nurse is caring for a client who has a new diagnosis of rheumatoid arthritis. Which of the following laboratory findings should the nurse expect?

• A. Increased WBC count.
• B. Decreased hemoglobin.
• C. Decreased platelet count.
• D. Positive rheumatoid factor.

Correct answer: D

Rationale: The correct answer is D: Positive rheumatoid factor. A positive rheumatoid factor is a common laboratory finding in clients with rheumatoid arthritis, indicating an autoimmune response. Option A, increased WBC count, is not typically associated with rheumatoid arthritis. Option B, decreased hemoglobin, and option C, decreased platelet count, are not specific laboratory findings for rheumatoid arthritis.

2. A healthcare provider is reviewing laboratory results for a client who has diabetes mellitus. Which of the following tests is an indicator of long-term blood glucose control?

• A. Fasting blood glucose
• B. Glycosylated hemoglobin (HbA1c)
• C. Random blood glucose
• D. Postprandial blood glucose

Correct answer: B

Rationale: The correct answer is B, Glycosylated hemoglobin (HbA1c). HbA1c provides a measure of long-term blood glucose control over the past 2-3 months. This test reflects the average blood glucose levels during this period, making it a valuable tool in managing diabetes. Choices A, C, and D are not indicators of long-term blood glucose control. Fasting blood glucose measures the current glucose level after a period of not eating, random blood glucose provides a snapshot of the current glucose level, and postprandial blood glucose measures the glucose level after a meal.

3. A nurse is assessing a client who has cirrhosis. Which of the following findings should the nurse expect?

• A. Clay-colored stools.
• B. Hypertension.
• C. Stridor.
• D. Elevated temperature.

Correct answer: A

Rationale: Clay-colored stools are a classic finding in a client with cirrhosis. Cirrhosis can lead to impaired bile flow, resulting in pale or clay-colored stools due to a lack of bilirubin in the stool. Hypertension, stridor, and elevated temperature are not typically associated with cirrhosis. Hypertension may occur in cirrhosis but is not a consistent finding, stridor is more commonly associated with upper airway obstruction, and elevated temperature may indicate an infection rather than a direct result of cirrhosis.

4. A client receiving warfarin is being taught by a nurse. Which of the following client statements indicates an understanding of the teaching?

• A. I will avoid eating leafy green vegetables while taking this medication.
• B. I will need to have my INR checked regularly while taking this medication.
• C. I will take this medication at the same time each day.
• D. I will avoid taking aspirin while taking this medication.

Correct answer: D

Rationale: The correct answer is D because clients taking warfarin should avoid aspirin to reduce the risk of bleeding, as both medications can thin the blood. Choice A is incorrect because it is essential to eat a consistent amount of leafy green vegetables to maintain a steady intake of Vitamin K, which can impact warfarin's effectiveness. Choice B is incorrect although important because INR checks are necessary but do not specifically show an understanding of the teaching. Choice C is incorrect because while taking warfarin at the same time each day is beneficial for consistency, it does not directly address the interaction with aspirin.

5. A healthcare professional is preparing to administer enoxaparin to a client. Which of the following actions should the healthcare professional take?

• A. Administer the medication intramuscularly.
• B. Inject the medication into the lateral abdominal wall.
• C. Massage the injection site after administration.
• D. Discard the prefilled syringe after expelling the air bubble.

Correct answer: B

Rationale: The correct answer is to inject the medication into the lateral abdominal wall when administering enoxaparin. This is the recommended technique to ensure proper absorption and prevent tissue damage. Choice A is incorrect because enoxaparin should be administered subcutaneously, not intramuscularly. Choice C is incorrect as massaging the injection site after administration is not recommended, as it can cause bruising and discomfort. Choice D is incorrect because the prefilled syringe should not be discarded after expelling the air bubble; it should be used for the injection.

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