Nursing Elites

1. A client with asthma asks how to use a peak flow meter. Which of the following instructions should the nurse provide?

• A. Use the peak flow meter at the same time each day.
• B. Take a slow, deep breath and blow out as hard as you can.
• C. Keep a log of your peak flow readings.
• D. Perform the test before using any bronchodilators.

Correct answer: D

Rationale: The correct answer is to instruct the client to perform the peak flow test before using any bronchodilators. This is important because it provides the most accurate baseline measurement of lung function. Choice A is not necessarily crucial for the accuracy of the test. Choice B describes the technique for spirometry, not peak flow meter use. Choice C, while important for tracking trends, is not directly related to the accuracy of the initial measurement.

2. A nurse is reviewing the laboratory values of a client who has diabetic ketoacidosis (DKA). Which of the following findings should the nurse report to the provider?

• A. Potassium 4.2 mEq/L
• B. Glucose 250 mg/dL
• C. Bicarbonate 20 mEq/L
• D. Sodium 135 mEq/L

Correct answer: B

Rationale: The correct answer is B. A glucose level of 250 mg/dL indicates hyperglycemia, which is expected in DKA. However, in the context of DKA management, persistent or worsening hyperglycemia can indicate inadequate treatment response or complications, necessitating further monitoring and intervention. Potassium levels are crucial in DKA due to the risk of hypokalemia, but a level of 4.2 mEq/L is within the normal range. Bicarbonate levels are typically low in DKA, making a value of 20 mEq/L consistent with the condition. Sodium levels of 135 mEq/L are also within normal limits and not a priority for immediate reporting in the context of DKA.

3. A nurse is preparing an in-service for a group of nurses about malpractice issues in nursing. Which of the following examples should the nurse include in the teaching?

• A. Leaving a nasogastric tube clamped after administering oral medication.
• B. Documenting communication with a provider in the progress notes of the client's medical records.
• C. Administering potassium via IV bolus.
• D. Placing a yellow bracelet on a client who is at risk for falls.

Correct answer: C

Rationale: Administering potassium via IV bolus is a malpractice issue due to the risk of cardiac complications. Option A is incorrect as leaving a nasogastric tube clamped after administering oral medication can lead to complications but is not directly linked to malpractice. Option B is incorrect as documenting communication with a provider in the progress notes is a necessary part of nursing practice. Option D is incorrect as placing a yellow bracelet on a client at risk for falls is a safety measure to prevent falls and is not related to malpractice issues.

4. During an in-service about nursing leadership, what information should the nurse include about an effective leader?

• A. Acts as an advocate for the nursing unit.
• B. Prioritizes staff requests over client needs.
• C. Shares personal opinions to influence the group's values.
• D. Provides routine client care and documentation.

Correct answer: A

Rationale: An effective leader advocates for the unit's success and its members. Choice B is incorrect because prioritizing staff requests over client needs does not align with effective leadership, which should focus on client-centered care. Choice C is incorrect as sharing personal opinions to influence the group's values can be biased and may not reflect the best interest of the team. Choice D is incorrect because while providing client care is essential, effective leadership involves more than routine tasks and includes guiding and supporting the team.

5. A nurse is caring for a client who has a prescription for furosemide. Which of the following findings should the nurse identify as an indication that the medication is effective?

• A. Weight loss of 0.5 kg (1.1 lb) in 24 hours.
• B. Increased urinary output.
• C. Blood pressure of 118/78 mm Hg.
• D. Decreased peripheral edema.

Correct answer: A

Rationale: The correct answer is A. Weight loss of 0.5 kg (1.1 lb) in 24 hours is an indication that furosemide is effectively reducing fluid retention. This medication works by promoting diuresis, resulting in increased urine output, which could lead to weight loss. While increased urinary output (choice B) is a common effect of furosemide, weight loss is a more specific indicator of its effectiveness. Blood pressure (choice C) and decreased peripheral edema (choice D) can be influenced by various factors and are not direct indicators of furosemide's effectiveness in reducing fluid retention.

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