Nursing Elites

1. A healthcare professional is reviewing the lab results of a client with liver disease. Which finding requires immediate intervention?

• A. Elevated bilirubin levels
• B. Low albumin levels
• C. Elevated ammonia levels
• D. Low hemoglobin levels

Correct answer: C

Rationale: Elevated ammonia levels in a client with liver disease can lead to hepatic encephalopathy, requiring immediate intervention. Ammonia is a neurotoxin that can cause cognitive impairment and altered mental status. Elevated bilirubin levels (Choice A) are common in liver disease but do not require immediate intervention. Low albumin levels (Choice B) and low hemoglobin levels (Choice D) are also common in liver disease but do not pose an immediate threat compared to elevated ammonia levels.

2. A nurse sees a healthcare provider administer an incorrect medication dose but does not report the error. What should the nurse do first?

• A. Ignore the situation and continue with patient care.
• B. Report the error to the nurse manager immediately.
• C. Speak to the healthcare provider directly about the error.
• D. File an anonymous report to avoid conflict.

Correct answer: B

Rationale: When a nurse witnesses a healthcare provider administering an incorrect medication dose, the first step should be to report the error to the nurse manager immediately. Reporting medication errors is crucial for patient safety as it allows prompt intervention to prevent harm. Choice A is incorrect as ignoring the situation can jeopardize patient safety. Choice C, while addressing the error directly, may not ensure proper documentation and follow-up. Choice D, filing an anonymous report, is not as effective as directly informing the nurse manager who can take appropriate action and follow-up on the incident.

3. A nurse is providing discharge instructions to a client following a gastrectomy. Which of the following strategies should the nurse include in the teaching?

• A. Drink fluids between meals
• B. Eat three large meals each day
• C. Lie down for 30 minutes after meals
• D. Avoid drinking liquids with meals

Correct answer: D

Rationale: The correct strategy to include in the teaching after a gastrectomy is to avoid drinking liquids with meals. This helps prevent dumping syndrome, a condition characterized by rapid emptying of undigested food and fluids from the stomach into the small intestine. Choices A, B, and C are incorrect. Drinking fluids between meals is appropriate to maintain hydration, eating three large meals can exacerbate dumping syndrome, and lying down after meals is not recommended as it can increase the risk of reflux.

4. A patient with a history of hypertension is admitted for chest pain. What is the most appropriate action for the nurse to take first?

• A. Obtain a detailed medical history
• B. Administer nitroglycerin
• C. Conduct an ECG
• D. Administer morphine sulfate

Correct answer: B

Rationale: The correct answer is to administer nitroglycerin. Nitroglycerin is the priority intervention for a patient presenting with chest pain as it helps dilate blood vessels, reduce chest pain, and improve oxygen supply to the heart. Obtaining a detailed medical history, conducting an ECG, or administering morphine sulfate are important steps in the assessment and treatment process but are secondary to the immediate need to address chest pain and potential cardiac ischemia.

5. The surgical mask the perioperative nurse is wearing becomes moist. Which action will the perioperative nurse take next?

• A. Do not change the mask if the nurse is comfortable.
• B. Change the mask when relieved by the next shift.
• C. Apply a new mask.
• D. Reapply the mask after it air-dries.

Correct answer: C

Rationale: When a surgical mask becomes moist, it loses its effectiveness as a barrier against microorganisms. Therefore, the perioperative nurse should apply a new mask. Choice A is incorrect because a moist mask should not be continued to be worn even if the nurse is comfortable. Choice B is not the best course of action as the mask should be changed immediately when it becomes moist. Choice D is also incorrect as waiting for the mask to air-dry is not recommended due to the loss of barrier effectiveness.

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