Nursing Elites

1. A healthcare provider is caring for a client who has asthma and is experiencing wheezing. Which of the following medications should the healthcare provider administer?

• A. Fluticasone
• B. Montelukast
• C. Albuterol
• D. Ipratropium

Correct answer: C

Rationale: Albuterol is a short-acting beta-agonist bronchodilator used to quickly relieve bronchospasm in clients with asthma who are experiencing wheezing. Fluticasone is an inhaled corticosteroid used for long-term control of asthma symptoms and not for acute wheezing. Montelukast is a leukotriene receptor antagonist used for long-term asthma management, not for immediate relief of wheezing. Ipratropium is an anticholinergic bronchodilator used for chronic obstructive pulmonary disease (COPD) and not typically used as the first-line treatment for asthma exacerbation.

2. A nurse is planning care for a client who is 6 hours postoperative following a total hip arthroplasty. Which of the following interventions should the nurse include in the plan of care?

• A. Place a wedge under the client's affected leg.
• B. Keep the client's hip flexed at a 90° angle.
• C. Position the client with the legs extended and the hip externally rotated.
• D. Keep the client's leg abductor pillow in place while in bed.

Correct answer: D

Rationale: In caring for a client 6 hours postoperative following a total hip arthroplasty, it is crucial to keep the leg abductor pillow in place while in bed. This intervention helps prevent hip dislocation by maintaining proper alignment and stability of the hip joint. Placing a wedge under the client's affected leg (Choice A) may not provide adequate support and could potentially compromise the surgical site. Keeping the client's hip flexed at a 90° angle (Choice B) or positioning the client with the legs extended and the hip externally rotated (Choice C) are not recommended post total hip arthroplasty as they may increase the risk of hip dislocation.

3. A nurse is reviewing the medical record of a client who has a new prescription for spironolactone. Which of the following findings should the nurse report to the provider?

• A. Potassium 4.0 mEq/L
• B. Calcium 9.5 mg/dL
• C. Magnesium 2.0 mEq/L
• D. Serum creatinine 3.0 mg/dL

Correct answer: D

Rationale: A serum creatinine level of 3.0 mg/dL indicates impaired kidney function, which is a concern when prescribing spironolactone as it can further affect renal function. Elevated serum creatinine levels may suggest decreased renal clearance of spironolactone, leading to potential toxicity. Potassium, calcium, and magnesium levels are within normal ranges and not directly related to spironolactone therapy. Therefore, the nurse should report the elevated serum creatinine level to the provider for further evaluation and possible dosage adjustment.

4. A nurse is caring for a client who has cirrhosis. Which of the following laboratory findings should the nurse expect?

• A. Increased bilirubin levels
• B. Decreased albumin levels
• C. Increased prothrombin time
• D. Decreased serum glucose levels

Correct answer: A

Rationale: Corrected Rationale: Increased bilirubin levels are expected in clients with cirrhosis due to impaired liver function. Elevated bilirubin levels are commonly seen in cirrhosis as the liver's ability to process bilirubin is compromised. Decreased albumin levels and increased prothrombin time are also associated with cirrhosis, but the most specific finding related to liver dysfunction among the choices provided is increased bilirubin levels. Decreased serum glucose levels are not typically associated with cirrhosis.

5. What is the most important assessment for a patient with respiratory distress?

• A. Monitor oxygen saturation
• B. Check for abnormal breath sounds
• C. Check for pitting edema
• D. Perform a neurological exam

Correct answer: A

Rationale: Monitoring oxygen saturation is crucial in assessing a patient with respiratory distress because it helps determine if the patient is receiving adequate oxygen. Oxygen saturation levels provide immediate feedback on the efficiency of oxygen delivery to the tissues. Checking for abnormal breath sounds (Choice B) is relevant in respiratory assessments, but it is secondary to assessing oxygen saturation. Pitting edema (Choice C) and performing a neurological exam (Choice D) are not directly related to assessing respiratory distress and are not the primary focus when managing a patient with breathing difficulties.

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