Nursing Elites

1. A nurse is providing care to a client who has thrombocytopenia. Which of the following actions should the nurse take?

• A. Encourage the client to floss daily.
• B. Remove fresh flowers from the client's room.
• C. Provide the client with a stool softener.
• D. Avoid serving raw vegetables.

Correct answer: C

Rationale: The correct answer is C: Provide the client with a stool softener. Thrombocytopenia is a condition characterized by a low platelet count, which can lead to an increased risk of bleeding. Providing the client with a stool softener helps prevent constipation, reduces the need for straining during bowel movements, and ultimately decreases the risk of bleeding. Choice A is incorrect as flossing daily does not directly address the issue of bleeding risk associated with thrombocytopenia. Choice B is incorrect as removing fresh flowers from the client's room is more related to the risk of infection rather than bleeding in thrombocytopenia. Choice D is incorrect as avoiding serving raw vegetables does not directly impact the risk of bleeding in clients with thrombocytopenia.

2. Which electrolyte imbalance is commonly seen in patients taking furosemide?

• A. Hypokalemia
• B. Hyponatremia
• C. Hyperkalemia
• D. Hypercalcemia

Correct answer: A

Rationale: The correct answer is A: Hypokalemia. Furosemide, a loop diuretic, can lead to potassium loss in the urine, resulting in hypokalemia. This electrolyte imbalance is commonly seen in patients taking furosemide and requires close monitoring. Choices B, C, and D are incorrect because furosemide does not typically cause hyponatremia, hyperkalemia, or hypercalcemia as frequently as it causes hypokalemia.

3. A nurse is caring for a client who has anemia and a hemoglobin level of 8 g/dL. Which of the following findings should the nurse expect?

• A. Jaundice.
• B. Bradycardia.
• C. Tachypnea.
• D. Hypertension.

Correct answer: C

Rationale: The correct answer is C: Tachypnea. Anemia leads to decreased oxygen-carrying capacity due to low hemoglobin levels, prompting the body to increase respiratory rate to enhance oxygen uptake. Jaundice (choice A) is associated with liver issues, not anemia. Bradycardia (choice B) and Hypertension (choice D) are not typically expected findings in clients with anemia; instead, tachycardia may occur as the body compensates for the decreased oxygen delivery.

4. A nurse is caring for a client who has severe hypertension and is receiving nitroprusside. What action should the nurse take?

• A. Administer oxygen and assess the client's response.
• B. Monitor blood pressure every 2 hours.
• C. Limit light exposure to the IV infusion.
• D. Attach an inline filter to the IV tubing.

Correct answer: C

Rationale: The correct action for the nurse to take when caring for a client receiving nitroprusside for severe hypertension is to limit light exposure to the IV infusion. Nitroprusside is light-sensitive, and exposure to light can lead to degradation of the medication, reducing its effectiveness. Administering oxygen (Choice A) may be necessary for some clients but is not directly related to the administration of nitroprusside. Monitoring blood pressure every 2 hours (Choice B) is a general nursing intervention for clients with hypertension but does not specifically address the administration of nitroprusside. Attaching an inline filter to the IV tubing (Choice D) is not necessary to address the specific concern of light exposure related to nitroprusside administration.

5. A nurse is assessing a client who has myasthenia gravis. Which of the following findings should the nurse expect?

• A. Bradycardia.
• B. Increased muscle strength.
• C. Diarrhea.
• D. Decreased deep tendon reflexes.

Correct answer: D

Rationale: The correct answer is D: Decreased deep tendon reflexes. In myasthenia gravis, muscle weakness is a common manifestation, leading to decreased deep tendon reflexes. Bradycardia (choice A) is not typically associated with myasthenia gravis. Increased muscle strength (choice B) is unlikely as muscle weakness is a hallmark of this condition. Diarrhea (choice C) is not a typical finding in myasthenia gravis.

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