Nursing Elites

1. A healthcare professional is preparing to administer digoxin to a client with heart failure. Which of the following laboratory values should the professional report to the provider?

• A. Potassium 4.0 mEq/L
• B. Calcium 9.5 mg/dL
• C. Sodium 140 mEq/L
• D. Magnesium 2.0 mg/dL

Correct answer: C

Rationale: The correct answer is C: Sodium 140 mEq/L. An elevated sodium level can affect the effectiveness of digoxin therapy and may lead to toxicity. Therefore, it is crucial to report this value to the provider. Potassium, calcium, and magnesium levels are important as well, but elevated sodium can have a more direct impact on digoxin therapy in this scenario.

2. A healthcare professional is reviewing the results of an ABG performed on a client with chronic emphysema. Which of the following results suggests the need for further treatment?

• A. PaO2 level of 89 mm Hg
• B. PaCO2 level of 55 mm Hg
• C. HCO3 level of 25 mEq/L
• D. pH level of 7.37

Correct answer: B

Rationale: The correct answer is B. A high PaCO2 level (55 mm Hg) in a client with chronic emphysema suggests respiratory acidosis, which requires further treatment. In chronic emphysema, impaired gas exchange leads to elevated carbon dioxide levels in the blood. Option A (PaO2 level of 89 mm Hg) is near the normal range and does not indicate immediate treatment. Option C (HCO3 level of 25 mEq/L) and option D (pH level of 7.37) are within normal limits and do not suggest the need for further treatment in this context.

3. A nurse is providing discharge teaching for a group of clients. The nurse should recommend a referral to a dietitian for which of the following clients?

• A. A client who has a prescription for warfarin and states, 'I will need to limit how much spinach I eat.'
• B. A client who has gout and states, 'I can continue to eat anchovies on my pizza.'
• C. A client who has a prescription for spironolactone and states, 'I will reduce my intake of foods that contain potassium.'
• D. A client who has osteoporosis and states, 'I'll plan to take my calcium carbonate with a full glass of water.'

Correct answer: B

Rationale: The correct answer is B. A client with gout who plans to continue consuming anchovies should be referred to a dietitian for proper dietary education. Anchovies are high in purines, which can exacerbate gout symptoms. Choices A, C, and D do not require immediate dietitian referral as the statements made by these clients are appropriate actions regarding their prescribed medications (warfarin and spinach intake, spironolactone and potassium intake, and calcium carbonate and water intake, respectively).

4. How should a healthcare professional respond to a patient who is experiencing confusion after surgery?

• A. Administer oxygen
• B. Reposition the patient
• C. Encourage deep breathing exercises
• D. Perform a neurological exam

Correct answer: A

Rationale: Administering oxygen is the most appropriate initial response to a patient experiencing confusion after surgery. Confusion can be a sign of hypoxia, which is inadequate oxygen supply to the brain. Administering oxygen helps ensure that the patient is getting enough oxygen, addressing a potential cause of the confusion. Repositioning the patient, encouraging deep breathing exercises, or performing a neurological exam may be necessary depending on the situation, but addressing potential hypoxia should be the priority in a confused post-operative patient.

5. What is the most effective intervention for a patient experiencing acute pain?

• A. Administer analgesics
• B. Reposition the patient
• C. Provide non-pharmacological interventions
• D. Administer IV fluids

Correct answer: A

Rationale: Administering analgesics is the most effective intervention for a patient experiencing acute pain as it directly targets the pain receptors and provides relief. Repositioning the patient may help in some cases, but it is not the primary intervention for managing acute pain. Non-pharmacological interventions can be beneficial as adjuncts to pain management but might not provide immediate relief. Administering IV fluids is not a standard intervention for acute pain unless dehydration is contributing to the pain.

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