Nursing Elites

1. A nurse is reviewing information about advance directives with a newly admitted client. Which statement by the client indicates an understanding of the teaching?

• A. My family can make decisions if I am unable to.
• B. I have a living will that outlines my wishes when I am unable to make a decision.
• C. I can write down my wishes, but they aren't legally binding.
• D. I don't need to worry about this until I’m critically ill.

Correct answer: B

Rationale: Choice B is the correct answer because having a living will is a legal document that outlines a client's wishes when they are unable to make decisions, indicating a good understanding of advance directives. Choice A is incorrect because it doesn't mention a specific document like a living will. Choice C is incorrect because advance directives, like a living will, can be legally binding. Choice D is incorrect because planning for advance directives should ideally be done before a person becomes critically ill.

2. A nurse is caring for a client receiving a dopamine infusion via a peripheral IV. Which of the following actions should the nurse take if the IV site appears infiltrated?

• A. Stop the infusion.
• B. Slow the infusion.
• C. Apply a warm compress to the site.
• D. Apply a cold compress to the site.

Correct answer: A

Rationale: Corrected Rationale: If infiltration is suspected, the nurse should immediately stop the dopamine infusion to prevent further damage to the surrounding tissue. Choice A is the correct answer because continuing the infusion can lead to tissue damage and compromise the client's care. Slowing the infusion (Choice B) is not sufficient to prevent harm and may still cause damage. Applying a warm compress (Choice C) or a cold compress (Choice D) is not the recommended action for infiltration; stopping the infusion is crucial to prevent complications.

3. A nurse is providing teaching for a client who has a new prescription for sertraline. Which of the following statements by the client indicates understanding?

• A. I will feel better immediately after starting this medication.
• B. I can expect to urinate frequently while taking this medication.
• C. I may experience difficulty sleeping while taking this medication.
• D. I should decrease my sodium intake while taking this medication.

Correct answer: C

Rationale: The correct answer is C: 'I may experience difficulty sleeping while taking this medication.' Sertraline can cause insomnia, especially when first starting the medication, so the client should be aware of this potential side effect. Choices A, B, and D are incorrect because feeling better immediately, increased urination, and decreasing sodium intake are not commonly associated side effects of sertraline.

4. A nurse is reviewing a laboratory report for a client who is at 33 weeks of gestation and has preeclampsia. Which of the following laboratory results should the nurse report to the provider?

• A. BUN 35 mg/dL
• B. Hgb 15 g/dL
• C. Bilirubin 0.6 mg/dL
• D. Hct 37%

Correct answer: A

Rationale: A BUN of 35 mg/dL indicates potential kidney impairment, which is a concern in preeclampsia due to compromised renal function. This finding warrants further evaluation by the provider. High BUN levels may suggest reduced kidney function, a common complication associated with preeclampsia. Hgb, Bilirubin, and Hct levels are within normal ranges and are not directly indicative of kidney impairment or preeclampsia in this scenario. Therefore, the nurse should report the elevated BUN level to the healthcare provider for prompt management and monitoring.

5. A healthcare professional is assessing a client for signs of dehydration. Which of the following should the healthcare professional look for?

• A. Bradycardia
• B. Dry mucous membranes
• C. Decreased urination
• D. Both B and C

Correct answer: D

Rationale: Corrected Rationale: Signs of dehydration include dry mucous membranes and decreased urination, among other symptoms. Bradycardia is not a typical sign of dehydration; instead, tachycardia (increased heart rate) is more commonly associated with dehydration. Therefore, option A is incorrect. While dry mucous membranes and decreased urination are indicative of dehydration, selecting only one of these symptoms would not provide a comprehensive assessment. Hence, option D, which includes both dry mucous membranes and decreased urination, is the correct choice.

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