Nursing Elites

1. A healthcare provider is reviewing a client's lab results. Which of the following lab values should the provider report?

• A. Magnesium 1.9 mEq/L
• B. Potassium 3.6 mEq/L
• C. Sodium 126 mEq/L
• D. Chloride 99 mEq/L

Correct answer: C

Rationale: The correct answer is C: Sodium 126 mEq/L. A sodium level of 126 mEq/L is below the normal range, indicating hyponatremia, which can have serious health implications and should be reported to the healthcare provider for further evaluation and intervention. Choices A, B, and D are within or close to the normal ranges for magnesium, potassium, and chloride, respectively, and do not require immediate reporting as they are not significantly abnormal.

2. A nurse is monitoring an older adult female client who had a myocardial infarction (MI) for the development of an acute kidney injury (AKI). Which of the following findings should the nurse identify as indicating an increased risk of AKI?

• A. Magnesium 2.0 mEq/L
• B. Blood urea nitrogen (BUN) 20 mg/dL
• C. Serum Osmolality 290 mOsm/kg H2O
• D. Serum creatinine 1.8 mg/dL

Correct answer: D

Rationale: An elevated serum creatinine level (1.8 mg/dL) is a significant indicator of potential kidney impairment. In acute kidney injury (AKI), serum creatinine levels rise due to decreased kidney function, reflecting the kidneys' inability to effectively filter waste from the blood. Magnesium level, BUN, and serum osmolality are not direct indicators of kidney function or risk of AKI. Magnesium levels are more related to electrolyte balance, BUN can be affected by factors other than kidney function, and serum osmolality reflects the concentration of solutes in the blood, not specifically kidney function.

3. What is the primary intervention for a client diagnosed with delirium?

• A. Provide a quiet and calm environment to minimize confusion
• B. Administer medication to reverse the symptoms of delirium
• C. Provide opportunities for social interaction to reduce isolation
• D. Encourage the client to remain physically active

Correct answer: A

Rationale: The correct answer is A: Provide a quiet and calm environment to minimize confusion. For clients diagnosed with delirium, creating a tranquil setting can help reduce agitation and disorientation. This intervention aims to decrease stimuli that may exacerbate symptoms. Administering medication (choice B) is not the primary intervention for delirium; it is usually reserved for specific underlying causes. While social interaction (choice C) and physical activity (choice D) are beneficial for overall well-being, they are not the primary interventions for managing delirium.

4. How does a healthcare professional assess a patient's fluid balance, and what signs indicate fluid overload?

• A. Checking lung sounds for crackles
• B. Checking for signs of orthopnea
• C. Monitoring intake and output, and checking for edema
• D. Measuring daily weight

Correct answer: C

Rationale: The correct answer is monitoring intake and output and checking for edema. Monitoring intake and output provides information about fluid balance in the body, while checking for edema helps assess for fluid overload. Lung sounds and signs of orthopnea are more indicative of respiratory issues rather than fluid balance. Daily weight measurement is useful to assess fluid status, but it alone may not provide a comprehensive evaluation of fluid balance.

5. A client with severe dyspnea is scheduled for multiple diagnostic tests. Which test should the nurse prioritize?

• A. Administer an echocardiogram first.
• B. Prioritize a chest x-ray for the client.
• C. Prepare the client for a CT scan.
• D. Order an MRI first.

Correct answer: B

Rationale: The correct answer is B: Prioritize a chest x-ray for the client. When a client presents with severe dyspnea, a chest x-ray should be prioritized as it helps in assessing the lungs and heart, which are crucial in cases of respiratory distress. Echocardiograms are more focused on assessing heart function and may not provide immediate information needed in cases of dyspnea. CT scans and MRIs are more detailed imaging studies that are not typically the first-line diagnostic tests for severe dyspnea.

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