Nursing Elites

1. A nurse is caring for a client who has deep vein thrombosis. Which of the following instructions should the nurse include in the plan of care?

• A. Limit the client's fluid intake to 1500 mL per day.
• B. Avoid massaging the affected extremity to relieve pain.
• C. Do not apply cold packs to the client's affected extremity.
• D. Elevate the client's affected extremity when in bed.

Correct answer: D

Rationale: The correct answer is to elevate the client's affected extremity when in bed. Elevating the extremity helps to reduce swelling and improve venous return in clients with DVT. Limiting fluid intake to 1500 mL per day (Choice A) is not directly related to managing DVT. Massaging the affected extremity (Choice B) can dislodge a clot and lead to serious complications. Applying cold packs (Choice C) can vasoconstrict blood vessels, potentially worsening the condition by reducing blood flow.

2. A healthcare professional is reviewing the laboratory results of a client who has chronic kidney disease. Which of the following findings should the healthcare professional report to the provider?

• A. Serum potassium 4.5 mEq/L
• B. Serum calcium 9.2 mg/dL
• C. Serum creatinine 2.5 mg/dL
• D. Serum albumin 3.5 g/dL

Correct answer: C

Rationale: Elevated serum creatinine levels indicate impaired kidney function. As kidney disease progresses, the kidneys are less able to filter waste products, leading to an increase in creatinine levels. Therefore, a high serum creatinine level of 2.5 mg/dL should be reported to the provider for further evaluation and management. Choices A, B, and D are within normal ranges and do not directly signify worsening kidney function in this context.

3. 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.

4. A nurse is providing discharge teaching to a client who has a new diagnosis of diabetes mellitus. Which of the following client statements indicates a need for further teaching?

• A. I will check my blood glucose level once a week.
• B. I will eat a snack if my blood glucose level is above 200 mg/dL.
• C. I will take my insulin as prescribed, even when I am feeling well.
• D. I will avoid physical activity if my blood glucose level is below 100 mg/dL.

Correct answer: B

Rationale: The correct answer is B. Clients should eat a snack when their blood glucose level is low, typically below 70-100 mg/dL, not when it is high. Eating a snack when the blood glucose level is above 200 mg/dL can exacerbate hyperglycemia. Choice A is correct as checking blood glucose levels regularly is important in managing diabetes. Choice C is also correct as adherence to prescribed insulin therapy is crucial. Choice D is incorrect as physical activity can help lower blood glucose levels, especially when they are above the target range.

5. Which medication is used to reverse the effects of opioid overdose?

• A. Naloxone
• B. Epinephrine
• C. Atropine
• D. Lidocaine

Correct answer: A

Rationale: Naloxone is the correct answer. Naloxone is specifically used to reverse the effects of opioid overdose by binding to opioid receptors and blocking the effects of opioids. Epinephrine is mainly used to treat severe allergic reactions, Atropine is used for certain types of heart conditions and to reduce salivation or respiratory secretions, and Lidocaine is a local anesthetic used for numbing purposes. Therefore, choices B, C, and D are incorrect in the context of reversing opioid overdose.

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