Nursing Elites

1. A healthcare professional is reviewing ABG laboratory results of a client who is in respiratory distress. The results are pH 7.47, PaCO2 32 mm Hg, and HCO3 22 mm Hg. The healthcare professional should recognize that the client is experiencing which of the following acid-base imbalances?

• A. Respiratory acidosis
• B. Respiratory alkalosis
• C. Metabolic acidosis
• D. Metabolic alkalosis

Correct answer: B

Rationale: The ABG results show a high pH (alkalosis) along with low PaCO2 and normal HCO3 levels, indicating respiratory alkalosis. In this condition, there is excessive loss of carbon dioxide (as seen by the low PaCO2) leading to a decrease in carbonic acid concentration and subsequent increase in pH. Metabolic acidosis or alkalosis would involve primary changes in bicarbonate levels, which are not predominant in this case.

2. A healthcare provider is reviewing the laboratory report of a client who has been taking lithium carbonate for the past 12 months. The provider notes a lithium level of 0.8 mEq/L. Which of the following orders from the provider should the healthcare provider expect?

• A. Withhold the next dose
• B. Increase the dosage
• C. Discontinue the medication
• D. Administer the medication

Correct answer: D

Rationale: A lithium level of 0.8 mEq/L falls within the therapeutic range for maintaining the drug's effectiveness while minimizing toxicity. Therefore, the appropriate action would be to continue administering the medication as prescribed by the healthcare provider to maintain the therapeutic effect for the client.

3. A client is experiencing preterm contractions and dehydration. Which of the following statements should the nurse make?

• A. Dehydration is treated with calcium supplements.
• B. Dehydration can increase the risk of preterm labor.
• C. Dehydration is associated with gastroesophageal reflux.
• D. Dehydration is caused by decreased hemoglobin and hematocrit.

Correct answer: B

Rationale: Dehydration can lead to an imbalance in electrolytes and cause uterine irritability, potentially leading to preterm contractions. It is essential for the nurse to educate the client on the importance of adequate hydration to reduce the risk of preterm labor. The statement 'Dehydration can increase the risk of preterm labor' directly addresses the client's condition and provides relevant information for their understanding and management of the situation.

4. While caring for a client in a clinic, a healthcare professional learns that the client woke up not recognizing their partner, surroundings, has chills, and chest pain worsening upon inspiration. What should be the healthcare professional's priority action?

• A. Obtain baseline vital signs and oxygen saturation.
• B. Obtain a sputum culture.
• C. Obtain a complete history from the client.
• D. Provide a pneumococcal vaccine.

Correct answer: A

Rationale: The priority action for the healthcare professional is to obtain the client's baseline vital signs and oxygen saturation. This will provide essential information on the client's current physiological status and help guide further assessment and intervention. Assessing the vital signs and oxygen saturation can help identify any immediate concerns like hypoxia or sepsis, which require prompt attention. While obtaining a complete history and considering a pneumococcal vaccine may be important in the overall care of the client, assessing the vital signs and oxygen saturation takes precedence to address the client's immediate physiological needs.

5. A healthcare professional realizes that the wrong medication has been administered to a client. Which of the following actions should the healthcare professional take first?

• A. Notify the provider.
• B. Report the incident to the healthcare facility's manager.
• C. Monitor vital signs.
• D. Fill out an incident report.

Correct answer: C

Rationale: In a situation where the wrong medication has been administered to a client, the immediate priority is to assess and monitor the client's vital signs to identify any adverse effects of the incorrect medication. This action takes precedence over notifying the provider, reporting the incident, or filling out an incident report. Monitoring vital signs allows for timely recognition and intervention if the client experiences any negative reactions to the wrong medication, ensuring their safety and well-being.

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