Nursing Elites

1. A nurse is caring for a client who is 1 day postoperative following a total knee replacement. Which of the following findings should the nurse report to the provider?

• A. Heart rate of 88/min
• B. Serous drainage on the dressing
• C. Temperature 37.3°C (99.1°F)
• D. Calf pain on dorsiflexion

Correct answer: D

Rationale: The correct answer is D. Calf pain on dorsiflexion following knee surgery may indicate a complication such as deep vein thrombosis, which is a serious condition requiring medical attention. Reporting this finding promptly is crucial to prevent further complications. Choices A, B, and C are within normal range for a client post knee surgery and do not typically indicate immediate complications that require urgent reporting.

2. A healthcare professional is reviewing the laboratory results of a client who is receiving total parenteral nutrition (TPN). Which of the following findings should the professional report to the provider?

• A. Blood glucose level of 130 mg/dL
• B. Serum sodium level of 140 mEq/L
• C. Serum potassium level of 3.2 mEq/L
• D. Platelet count of 250,000/mm³

Correct answer: C

Rationale: A serum potassium level of 3.2 mEq/L indicates hypokalemia, a complication that should be reported in clients receiving TPN. Hypokalemia can lead to serious cardiac and neuromuscular complications. The other options are within normal ranges and do not indicate immediate concerns for a client receiving TPN. A blood glucose level of 130 mg/dL, serum sodium level of 140 mEq/L, and platelet count of 250,000/mm³ are all considered normal values and do not require immediate intervention.

3. A healthcare provider is reviewing the medical records of a client with a prescription for combination oral contraceptives. Which of the following conditions is a contraindication?

• A. Hyperthyroidism
• B. Thrombophlebitis
• C. Diverticulosis
• D. Hypocalcemia

Correct answer: B

Rationale: Thrombophlebitis is a contraindication to combination oral contraceptives due to the increased risk of thromboembolic events. Hyperthyroidism, diverticulosis, and hypocalcemia are not contraindications to combination oral contraceptives. Hyperthyroidism may affect thyroid hormone levels but does not directly contraindicate oral contraceptives. Diverticulosis is a condition related to the digestive system and does not impact the use of oral contraceptives. Hypocalcemia, a low calcium level in the blood, is not a contraindication for oral contraceptives.

4. A nurse is caring for a client who is in a seclusion room following violent behavior. The client continues to display aggressive behavior. Which of the following actions should the nurse take?

• A. Confront the client about this behavior
• B. Express sympathy for the client's situation
• C. Speak assertively to the client
• D. Stand within 30 cm (1 ft) of the client when speaking with them

Correct answer: C

Rationale: In this situation, speaking assertively is the most appropriate action for the nurse to take. Confronting the client may escalate the situation further. Expressing sympathy, although important in other contexts, may not be effective in managing aggressive behavior. Standing within close proximity to an aggressive client can compromise the nurse's safety. Therefore, speaking assertively helps to set clear boundaries and manage the situation while ensuring safety in a seclusion room.

5. A healthcare provider is reviewing the laboratory data of a client who is receiving total parenteral nutrition. Which of the following findings should the healthcare provider report?

• A. Serum calcium 8.5 mg/dL
• B. Blood glucose level 120 mg/dL
• C. Serum sodium 138 mEq/L
• D. Serum albumin 3.5 g/dL

Correct answer: D

Rationale: The correct answer is D: Serum albumin 3.5 g/dL. A low serum albumin level indicates protein deficiency, which can be a complication of TPN therapy and requires prompt intervention. The other laboratory findings provided (serum calcium 8.5 mg/dL, blood glucose level 120 mg/dL, and serum sodium 138 mEq/L) are within normal ranges and do not specifically indicate complications related to TPN therapy.

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