Nursing Elites

1. A nurse is providing teaching about newborn care to a group of parents. Which of the following instructions should the nurse include?

• A. You should not bathe your newborn every day.
• B. You should avoid covering your newborn with a heavy blanket during naps.
• C. You should expect your newborn's stools to be soft and yellow.
• D. You should keep your newborn's head elevated while they sleep.

Correct answer: D

Rationale: The correct answer is D: 'You should keep your newborn's head elevated while they sleep.' Keeping the newborn's head elevated while sleeping helps prevent conditions like sudden infant death syndrome (SIDS). Choice A is incorrect because newborns do not need to be bathed every day; it is recommended to bathe them 2-3 times a week. Choice B is incorrect as heavy blankets can increase the risk of suffocation for newborns. Choice C is incorrect as newborn stools are typically soft and yellow in color, not firm and light brown.

2. A nurse is reviewing the medical record of a client who has chronic kidney disease. The client's potassium level is 6.5 mEq/L. Which of the following actions should the nurse take?

• A. Administer sodium bicarbonate
• B. Administer sodium polystyrene sulfonate
• C. Administer calcium gluconate
• D. Administer calcium carbonate

Correct answer: B

Rationale: The correct answer is B: Administer sodium polystyrene sulfonate. Sodium polystyrene sulfonate is used to treat hyperkalemia by promoting the excretion of potassium. Choice A, administering sodium bicarbonate, is incorrect as it is not used to treat hyperkalemia. Choice C, administering calcium gluconate, is incorrect as it is used to treat hypocalcemia, not hyperkalemia. Choice D, administering calcium carbonate, is incorrect as it is used to treat conditions like osteoporosis and indigestion, not hyperkalemia.

3. What is the best method to manage fluid overload in a patient with heart failure?

• A. Administer diuretics
• B. Provide oral fluids
• C. Increase fluid intake
• D. Provide chest physiotherapy

Correct answer: A

Rationale: Administering diuretics is the best method to manage fluid overload in a patient with heart failure. Diuretics help to remove excess fluid from the body by increasing urine output, thus reducing the fluid volume in the bloodstream and tissues. Providing oral fluids (choice B) or increasing fluid intake (choice C) would exacerbate the fluid overload rather than managing it. Chest physiotherapy (choice D) is not indicated for managing fluid overload in heart failure; it is more commonly used for conditions affecting the lungs or airways.

4. A healthcare professional is reviewing a client's laboratory results. Which of the following values is a contraindication to the administration of heparin?

• A. Hemoglobin 13 g/dL
• B. Platelet count 50,000/mm³
• C. White blood cell count 6,000/mm³
• D. INR 2.5

Correct answer: B

Rationale: The correct answer is B: Platelet count 50,000/mm³. A platelet count of 50,000/mm³ increases the risk of bleeding, making heparin contraindicated. Platelets are essential for blood clotting, and a low count can lead to excessive bleeding. Choices A, C, and D are not contraindications to heparin administration. Hemoglobin level of 13 g/dL is within the normal range, white blood cell count of 6,000/mm³ is also normal, and an INR of 2.5 is within the therapeutic range for patients receiving heparin therapy.

5. A nurse is assessing a client who is receiving morphine via a patient-controlled analgesia (PCA) pump. The nurse should identify that which of the following findings is a manifestation of opioid toxicity?

• A. Bradypnea.
• B. Tachycardia.
• C. Hypertension.
• D. Diaphoresis.

Correct answer: A

Rationale: Corrected Rationale: Bradypnea, or slow breathing, is a common sign of opioid toxicity. When a client is experiencing opioid toxicity, the respiratory system is usually the most affected, leading to a decrease in the respiratory rate (bradypnea). Tachycardia (increased heart rate), hypertension (high blood pressure), and diaphoresis (excessive sweating) are not typical manifestations of opioid toxicity. Therefore, the correct answer is bradypnea.

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