Nursing Elites

1. A client is scheduled to have his alanine aminotransferase (ALT) level checked. The client asks the nurse to explain the laboratory test. Which of the following is an appropriate response by the nurse?

• A. “This test will indicate if you are at risk for developing blood clots.”
• B. “This test will determine if your heart is performing properly.”
• C. “This test will provide information about the function of your liver.”
• D. “This test is used to check how your kidneys are working.”

Correct answer: C

Rationale: The correct answer is C: “This test will provide information about the function of your liver.” Alanine aminotransferase (ALT) is an enzyme mainly found in the liver. An elevated ALT level may indicate liver damage or disease. Choices A, B, and D are incorrect because ALT is specifically related to liver function and not indicative of blood clot risk, heart performance, or kidney function.

2. A client who is a Jehovah's Witness is admitted to the nursing unit. Which concern should the LPN have for planning care in terms of the client's beliefs?

• A. Autopsy of the body is prohibited.
• B. Blood transfusions are forbidden.
• C. Alcohol use in any form is not allowed.
• D. A vegetarian diet must be followed.

Correct answer: B

Rationale: The correct answer is B: 'Blood transfusions are forbidden.' Jehovah's Witnesses typically refuse blood transfusions due to their religious beliefs. This is crucial for the LPN to consider when planning the client's care to ensure that alternative treatments are explored. Choices A, C, and D are incorrect as they do not align with the specific beliefs and practices of Jehovah's Witnesses. Autopsy prohibition, alcohol use restrictions, and dietary preferences are not primary concerns related to the religious beliefs of Jehovah's Witnesses.

3. The healthcare provider is caring for a client with a wound infection. Which type of dressing is most appropriate to use to promote healing by secondary intention?

• A. Dry gauze dressing
• B. Wet-to-dry dressing
• C. Transparent film dressing
• D. Hydrocolloid dressing

Correct answer: D

Rationale: Hydrocolloid dressings are ideal for promoting healing by secondary intention in wound infections. These dressings create a moist environment that supports autolytic debridement and facilitates the healing process. Dry gauze dressings (Option A) may lead to adherence, causing trauma upon removal and disrupting the wound bed. Wet-to-dry dressings (Option B) are primarily used for mechanical debridement and can be painful during dressing changes. Transparent film dressings (Option C) are more suitable for superficial wounds with minimal exudate and are not typically used for wound infections requiring healing by secondary intention.

4. Which statement best describes time management strategies applied to the role of a nurse manager?

• A. Schedule staff efficiently to cover the needs of the managed unit
• B. Assume a fair share of direct client care to set an example
• C. Set daily goals with a prioritization of tasks
• D. Delegate tasks to reduce workload associated with direct care and meetings

Correct answer: C

Rationale: Setting daily goals and prioritizing tasks is crucial for effective time management as a nurse manager. This approach helps in organizing and focusing on the most important responsibilities, ensuring that key tasks are completed efficiently. Choice A is incorrect as scheduling staff efficiently, while important, is more related to staffing management than direct time management strategies. Choice B is incorrect as assuming direct client care does not necessarily align with effective time management strategies for a nurse manager, as their primary role is overseeing and coordinating care. Choice D, while delegation is a key aspect of time management, the emphasis on reducing workload specifically associated with direct care and meetings may not always be the primary focus of a nurse manager's time management strategies.

5. The nurse is preparing to administer insulin to a client with type 1 diabetes. Which assessment finding would require the nurse to hold the insulin and contact the healthcare provider?

• A. Blood glucose of 100 mg/dL
• B. Client reports feeling shaky
• C. Client ate only half of breakfast
• D. Client is sweating

Correct answer: A

Rationale: A blood glucose of 100 mg/dL is relatively low for administering insulin, especially if the client has not eaten adequately; further assessment and contacting the provider are necessary. Hypoglycemia can be a serious concern when administering insulin, and a blood glucose level of 100 mg/dL indicates a risk of hypoglycemia. Holding the insulin and contacting the healthcare provider is crucial to prevent hypoglycemia-related complications. Choices B, C, and D are not immediate concerns for holding insulin as they do not directly indicate a risk of hypoglycemic events.

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