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 client with acute diverticulitis should have which intervention included in the care plan?

• A. Administer a cleansing enema.
• B. Initiate a low-fiber diet.
• C. Apply moist heat to the abdomen.
• D. Provide a clear liquid diet.

Correct answer: B

Rationale: The correct intervention for a client with acute diverticulitis is to initiate a low-fiber diet. A low-fiber diet helps manage acute diverticulitis by reducing irritation to the colon, allowing it to heal. Administering a cleansing enema (Choice A) can worsen diverticulitis by increasing pressure within the colon. Applying moist heat to the abdomen (Choice C) may provide comfort but does not address the underlying cause. Providing a clear liquid diet (Choice D) is not ideal for diverticulitis management as it lacks the necessary nutrients for healing and may not provide enough bulk to prevent further irritation.

3. What is the priority nursing action for a patient with confusion post-surgery?

• A. Administer oxygen
• B. Reposition the patient
• C. Check oxygen saturation
• D. Perform a neurological exam

Correct answer: A

Rationale: The correct answer is to administer oxygen. Post-surgery, confusion in a patient could be due to hypoxia, a condition where the body is deprived of an adequate oxygen supply. Administering oxygen helps address hypoxia promptly, improving oxygen levels in the body and potentially resolving the confusion. Repositioning the patient, checking oxygen saturation, and performing a neurological exam may be important interventions but addressing hypoxia with oxygen administration takes precedence as the priority action.

4. While caring for a client receiving total parenteral nutrition (TPN), which of the following actions should the nurse take?

• A. Monitor the client's urine output every 8 hours.
• B. Administer a bolus of 0.9% sodium chloride.
• C. Check the client's blood glucose level every 4 hours.
• D. Flush the TPN line with sterile water before and after administration.

Correct answer: C

Rationale: Checking the client's blood glucose level every 4 hours is essential when managing a client on TPN to monitor for hyperglycemia, a common complication. Monitoring urine output (Choice A) is important but not a priority in this scenario. Administering a bolus of 0.9% sodium chloride (Choice B) is not indicated as it is unrelated to managing TPN. Flushing the TPN line with sterile water (Choice D) is necessary, but it should be done with 0.9% sodium chloride, not water.

5. How should a healthcare professional care for a patient with a central line to prevent infection?

• A. Change the dressing daily
• B. Monitor for redness
• C. Check the central line site every shift
• D. Flush the line with saline

Correct answer: A

Rationale: Corrected Rationale: Changing the central line dressing daily is crucial in preventing infection at the insertion site. This practice helps maintain a clean and sterile environment around the central line, reducing the risk of pathogens entering the bloodstream. Monitoring for redness (choice B) is important but may not directly prevent infection. Checking the central line site every shift (choice C) is essential for early detection of any issues but does not solely prevent infection. Flushing the line with saline (choice D) is a necessary procedure for maintaining central line patency but does not primarily prevent infection.

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