Nursing Elites

1. When caring for a client who is to have a line placed for hemodynamic monitoring, which statement by the newly licensed nurse indicates effectiveness of the teaching?

• A. Air should be instilled into the monitoring system after the procedure.
• B. The client should be positioned on the left side after the procedure.
• C. The transducer should be level with the second intercostal space after the line is placed.
• D. A chest x-ray is needed to verify placement after the procedure.

Correct answer: D

Rationale: After a line is placed for hemodynamic monitoring, it is crucial to confirm its correct placement. The definitive way to verify the placement is through a chest x-ray. This ensures that the line is appropriately positioned without complications. Options A, B, and C do not address the essential step of confirming the line's placement, making them incorrect choices.

2. If a patient's blood pressure is 150/96, what is his pulse pressure?

• A. 54
• B. 96
• C. 150
• D. 246

Correct answer: A

Rationale: Pulse pressure is calculated by subtracting the diastolic pressure from the systolic pressure. In this case, the systolic pressure is 150 and the diastolic pressure is 96. Therefore, the pulse pressure is 150 - 96 = 54. Pulse pressure represents the force generated by the heart with each contraction and is an important indicator of cardiovascular health.

3. A healthcare professional is reviewing laboratory data for a client who has chronic kidney disease. Which of the following findings should the healthcare professional expect?

• A. Increased creatinine.
• B. Increased hemoglobin.
• C. Increased bicarbonate.
• D. Increased calcium.

Correct answer: A

Rationale: In chronic kidney disease, the kidneys are unable to effectively filter waste products from the blood, leading to an accumulation of creatinine. Creatinine levels are commonly elevated in individuals with impaired kidney function, making it a key indicator of kidney health. Therefore, an increased creatinine level would be an expected finding in a client with chronic kidney disease.

4. When caring for a client on pressure support ventilation (PSV), which statement by the nurse indicates an understanding of PSV?

• A. It keeps the alveoli open and prevents atelectasis.
• B. It allows preset pressure delivered during spontaneous ventilation.
• C. It guarantees minimal minute ventilator.
• D. It delivers a preset ventilatory rate and tidal volume to the client.

Correct answer: B

Rationale: Pressure support ventilation (PSV) is a mode that delivers a preset pressure when the client initiates a breath. This support helps the client to breathe spontaneously by reducing the work of breathing. The correct statement indicating an understanding of PSV is that it allows preset pressure to be delivered during spontaneous ventilation, as it assists the client's efforts without controlling the rate or volume of each breath.

5. When preparing to administer an IM injection that is irritating to the subcutaneous tissue, what is the best action to prevent tracking of the medication?

• A. Use a small gauge needle
• B. Apply ice on the injection site
• C. Administer at a 45° angle
• D. Use the Z-track technique

Correct answer: D

Rationale: The Z-track technique is the best action to prevent tracking of the medication when administering an IM injection that is irritating to the subcutaneous tissue. This technique involves pulling the skin to the side before administering the injection and then releasing the skin after the injection. By doing so, a zig-zag pathway is created, preventing the medication from leaking into the subcutaneous tissue and reducing irritation. Options A, B, and C are incorrect. Using a small gauge needle may not prevent tracking of the medication. Applying ice on the injection site or administering at a 45° angle does not specifically address preventing tracking of the medication in cases where the injection is irritating to the subcutaneous tissue.

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