Nursing Elites

1. A client with diabetes mellitus and a new prescription for insulin is being discharged. Which of the following actions should the nurse plan to complete first?

• A. Provide the client with printed information on insulin self-administration.
• B. Obtain printed information on insulin self-administration.
• C. Make a copy of the medication reconciliation form for the client.
• D. Determine whether the client can afford the insulin administration supplies.

Correct answer: B

Rationale: Obtaining printed information on insulin self-administration should be the nurse's first priority. This action ensures that the client has the necessary knowledge to safely self-administer insulin at home. Providing the client with printed information (Choice A) is essential to empower the client with the required knowledge before considering additional resources. Making a copy of the medication reconciliation form for the client (Choice C) is important for documentation purposes but not as urgent as ensuring the client's understanding of insulin administration. Determining the client's ability to afford insulin administration supplies (Choice D) is crucial but should follow after ensuring the client is equipped with the necessary information for safe self-administration.

2. A client with chronic kidney disease is being assessed. Which laboratory value would be most concerning?

• A. Serum creatinine of 3.0 mg/dL
• B. Blood urea nitrogen (BUN) of 45 mg/dL
• C. Serum potassium of 6.5 mEq/L
• D. Hemoglobin of 10 g/dL

Correct answer: C

Rationale: In a client with chronic kidney disease, an elevated serum potassium level (hyperkalemia) is the most concerning finding. Hyperkalemia can lead to life-threatening cardiac dysrhythmias due to its effect on the electrical conduction system of the heart. Monitoring and managing serum potassium levels are crucial in patients with chronic kidney disease to prevent serious complications. While elevated serum creatinine (Choice A) and Blood Urea Nitrogen (BUN) levels (Choice B) indicate impaired kidney function, hyperkalemia poses an immediate risk of cardiac complications. Hemoglobin levels (Choice D) are typically lower in chronic kidney disease due to decreased erythropoietin production, but they do not present an immediate life-threatening risk like hyperkalemia.

3. A healthcare professional is preparing to insert an IV catheter into a client’s arm prior to initiating IV fluid therapy. Which of the following interventions should the healthcare professional implement to prevent infection?

• A. Thread the catheter up to the hub
• B. Use a sterile technique throughout the procedure
• C. Clean the insertion site with alcohol only
• D. Use gloves but not a mask during the procedure

Correct answer: B

Rationale: Using a sterile technique throughout the procedure is essential to prevent infection when inserting an IV catheter. This includes maintaining aseptic conditions, using sterile equipment, and following proper hand hygiene practices. Choice A is incorrect because threading the catheter up to the hub does not specifically address infection prevention. Choice C is incorrect as cleaning the insertion site with alcohol only may not provide adequate disinfection, as it is essential to use an antiseptic solution to reduce microbial load. Choice D is incorrect as wearing gloves alone is not sufficient protection against infection; a mask should also be worn to prevent the spread of microorganisms through respiratory secretions.

4. The healthcare provider prescribes the diuretic metolazone (Zaroxolyn) 7.5 mg PO. Zaroxolyn is available in 5 mg tablets. How much should the LPN/LVN plan to administer?

• A. 1/2 tablet.
• B. 1 tablet.
• C. 1 1/2 tablets.
• D. 2 tablets.

Correct answer: C

Rationale: To administer 7.5 mg of metolazone (Zaroxolyn), the LPN/LVN should plan to give 1 1/2 tablets since each tablet contains 5 mg. Choice A (1/2 tablet) would not provide the full prescribed dose. Choice B (1 tablet) would only deliver 5 mg, which is less than the prescribed dose. Choice D (2 tablets) would exceed the prescribed dose, resulting in 10 mg instead of the required 7.5 mg. Therefore, the correct answer is to administer 1 1/2 tablets to achieve the prescribed 7.5 mg.

5. A client reports mild back pain after receiving analgesia 1 hour ago. Which non-pharmacological pain method should the nurse plan to use?

• A. Apply an ice pack to the client's back for 1 hour.
• B. Remove distractions from the client’s room.
• C. Instruct the client to take deep rhythmic breaths.
• D. Encourage the client to apply a heating pad for 2 hours at a time.

Correct answer: C

Rationale: In this scenario, the nurse should instruct the client to take deep rhythmic breaths as a non-pharmacological pain management method. Deep breathing can help the client relax, reduce stress, and manage pain effectively. Applying heat or ice for prolonged periods can lead to tissue damage. Removing distractions can be helpful for promoting relaxation but may not directly address the pain itself.

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