Nursing Elites

1. A client requests the creation of a living will. Which of the following actions should the nurse take?

• A. Schedule a meeting between the hospital ethics committee and the client
• B. Evaluate the client's understanding of life-sustaining measures
• C. Determine the client's preferences about post-mortem care
• D. Request a conference with the client's family

Correct answer: B

Rationale: The correct action for the nurse to take when a client requests the creation of a living will is to evaluate the client's understanding of life-sustaining measures. This step is crucial to ensure that the client is well-informed about their options before making decisions regarding their future care. Scheduling a meeting with the hospital ethics committee (choice A) may not be necessary at this stage and could overwhelm the client. Determining the client's preferences about post-mortem care (choice C) is not directly related to creating a living will. Requesting a conference with the client's family (choice D) may be important later but is not the initial step in this situation.

2. A nurse is preparing to teach a client about the use of a peak flow meter. Which of the following instructions should the nurse include?

• A. Place the mouthpiece in your mouth and blow out as quickly as you can.
• B. Exhale slowly into the mouthpiece over 5 seconds.
• C. Take a slow deep breath before blowing into the mouthpiece.
• D. Blow into the mouthpiece at a steady rate for 3 seconds.

Correct answer: A

Rationale: The correct instruction for using a peak flow meter is to place the mouthpiece in your mouth and blow out as quickly as you can. This action helps measure the peak expiratory flow of the client. Choice B is incorrect because exhaling slowly does not provide an accurate peak flow reading. Choice C is incorrect as taking a slow deep breath before blowing interferes with obtaining an accurate measurement. Choice D is incorrect as blowing at a steady rate for 3 seconds may not reflect the peak expiratory flow accurately.

3. A nurse in a pediatric clinic is reviewing the laboratory test results of a school-age child. Which of the following findings should the nurse report to the provider?

• A. Hgb 12.5 g/dL.
• B. Platelets 250,000/mm³.
• C. Hct 40%.
• D. WBC 14,000/mm³.

Correct answer: D

Rationale: The correct answer is D. A WBC count of 14,000/mm³ is elevated, indicating a potential infection or inflammation, and should be reported to the provider for further evaluation and management. Choices A, B, and C are within normal ranges and do not require immediate reporting as they indicate normal hemoglobin, platelet count, and hematocrit levels for a school-age child.

4. A client at risk for osteoporosis is receiving teaching from a nurse. Which of the following client statements indicates an understanding of the teaching?

• A. I will avoid weight-bearing exercises.
• B. I should increase my intake of vitamin D.
• C. I should reduce my intake of dairy products.
• D. I will increase my intake of foods high in calcium.

Correct answer: B

Rationale: The correct answer is B: 'I should increase my intake of vitamin D.' Adequate vitamin D intake is crucial for calcium absorption, which is essential for bone health and preventing osteoporosis. Avoiding weight-bearing exercises (choice A) would be detrimental as weight-bearing activities help improve bone density. Reducing dairy intake (choice C) is not recommended as dairy products are a good source of calcium. While increasing calcium intake (choice D) is important, ensuring sufficient vitamin D levels for proper absorption is equally crucial for bone health.

5. A healthcare professional is reviewing laboratory results for a client who has cirrhosis. Which of the following findings should the professional report to the provider?

• A. Albumin 3.5 g/dL
• B. Bilirubin 1.0 mg/dL
• C. INR 3.0
• D. Ammonia 80 mcg/dL

Correct answer: C

Rationale: An INR of 3.0 is elevated, indicating impaired blood clotting function, which poses a significant risk of bleeding in clients with cirrhosis. This finding should be promptly reported to the provider for further evaluation and management. Choice A (Albumin 3.5 g/dL) is within the normal range and indicates adequate liver synthetic function, so it does not require immediate reporting. Choice B (Bilirubin 1.0 mg/dL) is also within the normal range and typically seen in clients without significant liver dysfunction, so it does not need urgent attention. Choice D (Ammonia 80 mcg/dL) is elevated, but it is not the priority finding in cirrhosis; elevated ammonia levels are associated with hepatic encephalopathy rather than increased bleeding risk.

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