Nursing Elites

1. A nurse is caring for a client who has cirrhosis. Which of the following laboratory values should the nurse expect to be decreased?

• A. Bilirubin.
• B. Albumin.
• C. Ammonia.
• D. Prothrombin time.

Correct answer: B

Rationale: In clients with cirrhosis, albumin levels are typically decreased due to impaired liver function. Bilirubin levels are often increased in cirrhosis due to the liver's inability to process bilirubin efficiently. Ammonia levels may be elevated in cirrhosis due to impaired ammonia metabolism by the liver. Prothrombin time is usually prolonged in cirrhosis because the liver's ability to synthesize clotting factors is impaired.

2. A nurse in an emergency department is assessing a client who reports ingesting thirty diazepam tablets and has a respiratory rate of 10/min. After securing the client's airway and initiating an IV, which of the following actions should the nurse do next?

• A. Monitor the client's IV site for thrombophlebitis
• B. Administer flumazenil to the client
• C. Evaluate the client for further suicidal behavior
• D. Initiate seizure precautions for the client

Correct answer: B

Rationale: Administering flumazenil is the priority to reverse the effects of diazepam overdose. Monitoring the IV site for thrombophlebitis (choice A) is important but not the next immediate action. Evaluating the client for further suicidal behavior (choice C) is important but not the priority at this moment. Initiating seizure precautions (choice D) is not the priority action in this scenario.

3. A client is receiving intermittent enteral tube feedings. Which of the following places the client at risk for aspiration?

• A. A history of gastroesophageal reflux disease.
• B. Receiving a high-osmolarity formula.
• C. Sitting in a high-Fowler's position during the feeding.
• D. A residual of 65 mL 1 hr post-feeding.

Correct answer: A

Rationale: The correct answer is A. Clients with a history of gastroesophageal reflux disease are at risk for aspiration due to the potential of regurgitation, which can lead to aspiration of stomach contents into the lungs. Choice B (receiving a high-osmolarity formula) can lead to issues like diarrhea or dehydration but is not directly related to aspiration. Choice C (sitting in a high-Fowler's position during the feeding) is actually a preventive measure to reduce the risk of aspiration. Choice D (a residual of 65 mL 1 hr post-feeding) is a concern for delayed gastric emptying but not a direct risk factor for aspiration.

4. Which medication is used to manage hyperthyroidism?

• A. Levothyroxine
• B. Methimazole
• C. Propylthiouracil
• D. Prednisone

Correct answer: B

Rationale: Methimazole is the correct answer. It is commonly used to manage hyperthyroidism by inhibiting the production of thyroid hormones. Levothyroxine (Choice A) is actually a medication used to treat hypothyroidism by supplementing thyroid hormones. Propylthiouracil (Choice C) is another anti-thyroid medication used in the management of hyperthyroidism. Prednisone (Choice D) is a corticosteroid and is not typically used in the treatment of hyperthyroidism.

5. What is the best nursing action for a patient experiencing shortness of breath?

• A. Administer oxygen
• B. Administer bronchodilators
• C. Reposition the patient
• D. Provide IV fluids

Correct answer: A

Rationale: Administering oxygen is the best nursing action for a patient experiencing shortness of breath as it helps alleviate the symptoms and improve oxygenation. Providing oxygen addresses the primary issue of inadequate oxygen levels in the body, which can be a life-threatening situation. Administering bronchodilators (choice B) may be appropriate for specific respiratory conditions like asthma but is not the initial intervention for all causes of shortness of breath. Repositioning the patient (choice C) can sometimes help improve breathing, but in a patient experiencing significant shortness of breath, immediate oxygen therapy is crucial. Providing IV fluids (choice D) is not indicated as the first-line intervention for shortness of breath unless there is a specific underlying cause such as dehydration.

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