Nursing Elites

1. A healthcare provider is reviewing the health history of an older adult who has a hip fracture. The healthcare provider should identify what as a risk factor for developing pressure injuries?

• A. Advanced age
• B. Urinary incontinence
• C. Regular skin assessments
• D. Adequate hydration

Correct answer: B

Rationale: Urinary incontinence is a significant risk factor for skin breakdown and pressure injuries. It can lead to prolonged skin exposure to moisture and irritants, increasing the susceptibility to pressure injuries. Advanced age (Choice A) is a risk factor due to changes in skin integrity and decreased tissue viability, but it is not as direct a risk factor as urinary incontinence. Regular skin assessments (Choice C) are important for early detection and prevention but are not a risk factor themselves. Adequate hydration (Choice D) is essential for overall skin health but is not a direct risk factor for pressure injuries.

2. A nurse is teaching a client about the use of clopidogrel. Which of the following should be included?

• A. It is an anticoagulant
• B. Monitor for signs of bleeding
• C. It can be stopped abruptly
• D. Avoid foods rich in vitamin K

Correct answer: B

Rationale: The correct answer is B: 'Monitor for signs of bleeding.' Clopidogrel is an antiplatelet medication, not an anticoagulant. Clients taking clopidogrel should be monitored for signs of bleeding due to its antiplatelet effects. Choice A is incorrect because clopidogrel is not an anticoagulant. Choice C is incorrect as clopidogrel should not be stopped abruptly but as directed by a healthcare provider. Choice D is irrelevant since foods rich in vitamin K are more of a concern with anticoagulant medications like warfarin, not antiplatelet medications like clopidogrel.

3. A client is being educated by a nurse about the use of bupropion. Which of the following should be included?

• A. It can cause weight gain
• B. It may increase seizure risk
• C. It is an SSRI
• D. It has no side effects

Correct answer: B

Rationale: The correct answer is B. Bupropion may lower the seizure threshold, increasing the risk of seizures, especially in clients with a history of seizures. Choice A is incorrect because bupropion is associated with weight loss rather than weight gain. Choice C is incorrect as bupropion is not an SSRI; it is an aminoketone antidepressant. Choice D is incorrect as bupropion, like all medications, can have side effects, and it is essential for clients to be aware of them.

4. A client who gave birth 12 hours ago is experiencing excessive vaginal bleeding. Which of the following findings indicates the client is experiencing decreased cardiac output?

• A. Bradycardia
• B. Flushed face
• C. Hypotension
• D. Polyuria

Correct answer: C

Rationale: Hypotension is a key indicator of decreased cardiac output, especially in the context of postpartum hemorrhage, which can lead to significant fluid volume loss and compromise perfusion. In this scenario, the excessive vaginal bleeding could lead to hypovolemia, resulting in decreased cardiac output and subsequent hypotension. Bradycardia (choice A) is not typically associated with decreased cardiac output in this scenario, as the body often compensates for decreased cardiac output by increasing heart rate. A flushed face (choice B) may indicate vasodilation but is not a direct indicator of decreased cardiac output. Polyuria (choice D) is excessive urination and is not a specific indicator of decreased cardiac output in this context.

5. What can cause a low pulse oximetry reading?

• A. Hyperthermia
• B. Increased hemoglobin level
• C. Inadequate peripheral circulation
• D. Low altitudes

Correct answer: C

Rationale: Inadequate peripheral circulation can cause a low pulse oximetry reading by limiting blood flow to the area being measured, leading to inaccurate oxygen saturation readings. Hyperthermia (choice A) is an elevated body temperature and does not directly affect pulse oximetry readings. An increased hemoglobin level (choice B) would actually lead to higher oxygen-carrying capacity in the blood, resulting in normal or increased pulse oximetry readings. Low altitudes (choice D) typically do not cause low pulse oximetry readings unless there are other underlying conditions affecting oxygen levels.

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