Nursing Elites

1. A healthcare professional is reviewing a client's laboratory report and notes that the serum calcium level is 4.0 mg/dL. The healthcare professional understands that which condition most likely caused this serum calcium level?

• A. Prolonged bed rest
• B. Renal insufficiency
• C. Hyperparathyroidism
• D. Excessive ingestion of vitamin D

Correct answer: A

Rationale: Prolonged bed rest can lead to hypocalcemia due to decreased mobility and bone resorption. In this scenario, the low serum calcium level of 4.0 mg/dL is likely a result of decreased bone activity and calcium release due to prolonged bed rest. Renal insufficiency would more likely lead to hypercalcemia due to impaired excretion of calcium by the kidneys. Hyperparathyroidism is characterized by increased calcium levels as a result of excess parathyroid hormone. Excessive ingestion of vitamin D can cause hypercalcemia by increasing intestinal absorption of calcium.

2. Which of the following is the best argument for lower patient-to-nurse ratio?

• A. The more patients a nurse has, the better the nurse will be at catching early warning signs.
• B. Greater patient-to-nurse ratios decrease patient mortality.
• C. Adequate nurse levels do not impact the prevalence of urinary tract infections.
• D. Community nursing ratios do not impact Methicillin-resistant Staphylococcus aureus (MRSA) rates.

Correct answer: B

Rationale: The best argument for lower patient-to-nurse ratios is that they decrease patient mortality. Choice A is incorrect because having more patients can lead to increased workload and decreased attention per patient. Choice C is incorrect as adequate nurse levels can indeed impact the prevalence of infections. Choice D is incorrect as community nursing ratios can impact MRSA rates due to potential transmission risks in healthcare settings.

3. Which preventive measure can be employed to decrease the risk of compartment syndrome?

• A. The administration of a potassium-sparing diuretic for heart failure
• B. A bivalve cast for a skeletal fracture
• C. A cerebral diuretic to decrease intracranial pressure after a head injury
• D. A chest tube to restore normal intrathoracic pressure after a pneumothorax

Correct answer: B

Rationale: The correct answer is B. A bivalve cast can help decrease the risk of compartment syndrome by providing space for swelling, thus preventing the build-up of pressure within the muscles. Choices A, C, and D are incorrect because they are not directly related to preventing compartment syndrome. Choice A is more focused on managing heart failure, choice C on reducing intracranial pressure, and choice D on restoring intrathoracic pressure after a pneumothorax, which are not relevant to preventing compartment syndrome.

4. A client diagnosed with type 1 diabetes receives insulin. He asks the nurse why he can't just take pills instead. What is the best response by the nurse?

• A. Insulin must be injected because it needs to work quickly.
• B. Insulin can't be in a pill because it is destroyed in stomach acid.
• C. Have you talked to your doctor about taking pills instead?
• D. I know it is tough, but you will get used to the shots soon.

Correct answer: B

Rationale: The correct answer is B because insulin cannot be taken orally as it gets destroyed by stomach acid. Choice A is incorrect as the speed of action is not the reason why insulin can't be in pill form. Choice C is incorrect as it doesn't address the nature of insulin. Choice D is incorrect as it doesn't provide a factual reason why insulin can't be in pill form.

5. While administering penicillin intravenously, you notice that the patient becomes hypotensive with a bounding, rapid pulse rate. What is the first action you should take?

• A. Decrease the rate of the intravenous medication flow.
• B. Increase the rate of the intravenous medication flow.
• C. Call the doctor.
• D. Stop the intravenous flow.

Correct answer: D

Rationale: The correct action to take when a patient becomes hypotensive with a bounding, rapid pulse rate after administering penicillin intravenously is to stop the intravenous flow immediately. This can help prevent further complications by discontinuing the administration of the medication that might be causing the adverse effects. Decreasing or increasing the rate of medication flow may not address the underlying issue of the patient's adverse reaction. While it's important to involve the healthcare provider in such situations, the immediate priority is to halt the administration of the medication.

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