Nursing Elites

1. A nurse is planning care for a client who has chronic kidney disease. The nurse should identify which of the following laboratory values as an indication for hemodialysis?

• A. Glomerular filtration rate of 14 mL/minute
• B. BUN 16 mg/dL
• C. Serum magnesium 1.8 mg/dL
• D. Serum phosphorus 4.0 mg/dL

Correct answer: A

Rationale: A glomerular filtration rate of 14 mL/minute indicates severe kidney dysfunction, necessitating hemodialysis. The other options, BUN of 16 mg/dL, serum magnesium of 1.8 mg/dL, and serum phosphorus of 4.0 mg/dL, are within normal ranges and do not serve as indications for hemodialysis.

2. A client is immediately postoperative following a hip arthroplasty. Which of the following positions should the nurse maintain for the client?

• A. Supine with legs extended
• B. Semi-Fowler's position with legs bent
• C. Lateral position with an abduction pillow between the legs
• D. Prone with legs elevated

Correct answer: C

Rationale: The correct position for a client immediately postoperative following a hip arthroplasty is the lateral position with an abduction pillow between the legs. This position helps prevent dislocation of the hip prosthesis and maintains proper alignment of the hip joint. Supine position with legs extended (Choice A) may put stress on the hip joint, Semi-Fowler's position with legs bent (Choice B) may not provide adequate support and alignment, and prone position with legs elevated (Choice D) is not recommended after hip arthroplasty as it can compromise the surgical site and increase the risk of complications.

3. A nurse is assessing a client who has a potassium level of 3.0 mEq/L. Which of the following findings should the nurse expect?

• A. Diarrhea
• B. Muscle weakness
• C. Hypertension
• D. Bradycardia

Correct answer: B

Rationale: Muscle weakness is a common finding in clients with hypokalemia, as potassium is essential for proper muscle function. Diarrhea (choice A) is more commonly associated with hyperkalemia rather than hypokalemia. Hypertension (choice C) is not typically a direct result of low potassium levels. Bradycardia (choice D) is more commonly associated with hyperkalemia, not hypokalemia.

4. What is the appropriate action for a patient experiencing a severe allergic reaction?

• A. Administer epinephrine
• B. Administer antihistamines
• C. Administer corticosteroids
• D. Administer oxygen

Correct answer: A

Rationale: The correct answer is to administer epinephrine. Epinephrine is the first-line treatment for severe allergic reactions as it helps reverse the symptoms rapidly by constricting blood vessels, increasing heart rate, and opening airways. Antihistamines (Choice B) may help with mild allergic reactions but are not effective for severe cases. Corticosteroids (Choice C) are used to reduce inflammation and are typically not the first-line treatment for acute severe allergic reactions. Administering oxygen (Choice D) may be necessary to support breathing in severe cases, but epinephrine is the primary treatment to reverse the allergic reaction symptoms.

5. What is the priority nursing action for a patient with respiratory distress?

• A. Administer oxygen
• B. Reposition the patient
• C. Administer bronchodilators
• D. Provide chest physiotherapy

Correct answer: A

Rationale: The priority nursing action for a patient with respiratory distress is to administer oxygen. Oxygen therapy is crucial in improving oxygenation levels and relieving respiratory distress, making it the top priority intervention. Repositioning the patient, administering bronchodilators, or providing chest physiotherapy may be necessary interventions depending on the underlying cause, but ensuring adequate oxygen supply should take precedence in addressing respiratory distress.

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