Nursing Elites

1. A nurse is caring for a client who has pneumonia. Which of the following findings should the nurse report to the provider immediately?

• A. Increased appetite
• B. Productive cough with green sputum
• C. Cyanosis of the lips and nail beds
• D. Mild shortness of breath

Correct answer: C

Rationale: The correct answer is C: Cyanosis of the lips and nail beds. Cyanosis is a late sign of hypoxia and indicates severe oxygen deprivation, requiring immediate intervention in clients with pneumonia. Reporting this finding promptly is crucial to prevent further complications. Choices A, B, and D are incorrect because increased appetite, productive cough with green sputum, and mild shortness of breath are common findings in clients with pneumonia and may not require immediate intervention unless they worsen or are accompanied by other concerning symptoms.

2. What should the healthcare provider monitor for a patient receiving furosemide?

• A. Monitor urine output
• B. Monitor blood pressure
• C. Monitor potassium levels
• D. Monitor serum creatinine

Correct answer: C

Rationale: The correct answer is to monitor potassium levels when a patient is receiving furosemide because furosemide can cause potassium depletion. It is essential to monitor potassium levels to prevent complications such as hypokalemia. While monitoring urine output is important in assessing kidney function, and monitoring blood pressure and serum creatinine are relevant in certain situations, the priority when administering furosemide is to monitor potassium levels due to the medication's potential to deplete potassium.

3. A nurse is caring for a client who is newly diagnosed with pancreatic cancer and has questions about the disease. To research, the nurse should identify which of the following electronic databases has the most comprehensive collection of nursing articles?

• A. MEDLINE
• B. CINAHL
• C. ProQuest
• D. Health Source

Correct answer: B

Rationale: The correct answer is B, CINAHL. CINAHL is specifically dedicated to nursing and allied health literature, making it the most appropriate database for nursing articles and research. It provides a comprehensive collection of nursing-related articles, journals, and research studies, which are essential for evidence-based practice. MEDLINE, on the other hand, is a valuable resource for medical literature but is not as nursing-focused as CINAHL. ProQuest and Health Source cover a wider range of subjects beyond nursing, so they are not as comprehensive when it comes to nursing-specific articles and research. Therefore, for the nurse looking to access a database with a vast collection of nursing articles, CINAHL is the most suitable option.

4. What is the best intervention for a patient with a suspected pulmonary embolism?

• A. Administer oxygen
• B. Administer anticoagulants
• C. Reposition the patient
• D. Administer bronchodilators

Correct answer: A

Rationale: Administering oxygen is the best intervention for a patient with a suspected pulmonary embolism because it helps alleviate respiratory distress and improve oxygenation. Oxygen therapy is crucial to ensure adequate oxygen levels in the blood due to the obstruction in the pulmonary circulation caused by the embolism. Administering anticoagulants (choice B) is a treatment for confirmed pulmonary embolism rather than a suspected case. Repositioning the patient (choice C) or administering bronchodilators (choice D) would not directly address the underlying issue of impaired gas exchange and oxygen delivery associated with pulmonary embolism.

5. A client is receiving heparin therapy. Which of the following laboratory results indicates the client is receiving an effective dose of heparin?

• A. INR 1.5
• B. aPTT 60 seconds
• C. Platelets 150,000/mm³
• D. Potassium 4.0 mEq/L

Correct answer: B

Rationale: An aPTT of 60 seconds indicates the client is receiving an effective dose of heparin. The activated partial thromboplastin time (aPTT) measures the time it takes for a clot to form, and a therapeutic range for heparin therapy is usually 1.5 to 2 times the control value, which is around 60-80 seconds. An INR of 1.5 is not related to heparin therapy, as it is commonly used to monitor warfarin therapy. Platelet count and potassium levels are not direct indicators of the effectiveness of heparin therapy.

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