Nursing Elites

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

• A. Temperature of 38°C (100.4°F).
• B. Urinary output of 40 mL/hr.
• C. Heart rate of 92/min.
• D. Capillary refill time of 2 seconds.

Correct answer: B

Rationale: The correct answer is B. A urinary output of 40 mL/hr is below the expected range and should be reported to the provider as it may indicate impaired kidney function, which is crucial to monitor in a client with septic shock. Choices A, C, and D are within acceptable ranges for a client with septic shock and do not indicate immediate concerns. A temperature of 38°C (100.4°F) is slightly elevated but can be expected in septic shock. A heart rate of 92/min is within the normal range for an adult. A capillary refill time of 2 seconds is also normal, indicating adequate peripheral perfusion.

2. A client is receiving chemotherapy and is being taught about preventing infection. Which of the following instructions should the nurse include?

• A. Take your temperature daily.
• B. Avoid fresh fruits and vegetables.
• C. Limit your intake of high-protein foods.
• D. Increase your intake of high-fat foods.

Correct answer: B

Rationale: Clients receiving chemotherapy are instructed to avoid fresh fruits and vegetables to lower the risk of infection. Fresh produce may harbor bacteria or other pathogens that could be harmful to individuals with compromised immune systems. Taking the temperature daily may be important but is not directly related to preventing infection. Limiting high-protein foods is not necessary unless there are specific dietary restrictions due to the treatment plan. Increasing the intake of high-fat foods is not recommended during chemotherapy as a high-fat diet may lead to other health issues.

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

• A. Platelet count 150,000/mm³
• B. aPTT 30 seconds
• C. Sodium 140 mEq/L
• D. Serum creatinine 3.0 mg/dL

Correct answer: D

Rationale: An elevated serum creatinine level indicates impaired kidney function, which can affect the metabolism and excretion of enoxaparin, potentially leading to increased drug levels and risk of bleeding. Therefore, it is crucial to report a high serum creatinine level before administering enoxaparin. Platelet count, aPTT, and sodium levels are not directly related to the administration of enoxaparin and would not impact its use; hence, they do not need to be reported before starting the medication.

4. 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.

5. A nurse is providing teaching to a client who has a new prescription for prednisone. Which of the following client statements indicates an understanding of the teaching?

• A. I will avoid crowded places to reduce my risk of infection.
• B. I will take this medication on an empty stomach.
• C. I will stop taking this medication if I experience nausea.
• D. I will take this medication for 2 weeks and then stop.

Correct answer: A

Rationale: The correct answer is A: 'I will avoid crowded places to reduce my risk of infection.' When taking prednisone, clients should avoid crowded places to reduce the risk of infection due to its immunosuppressive effects. Choice B is incorrect because prednisone is usually taken with food to reduce stomach upset. Choice C is incorrect because clients should not stop taking prednisone abruptly, even if they experience nausea. Choice D is incorrect because prednisone should be tapered off gradually under healthcare provider guidance instead of being stopped abruptly after 2 weeks.

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