Nursing Elites

1. A healthcare professional is reviewing the laboratory report of a client who is receiving filgrastim. Which of the following laboratory values should the healthcare professional monitor to determine the effectiveness of the treatment?

• A. WBC count.
• B. Serum potassium.
• C. Hemoglobin level.
• D. Serum creatinine.

Correct answer: A

Rationale: Filgrastim works by stimulating the production of white blood cells. Therefore, monitoring the white blood cell (WBC) count is essential to assess the effectiveness of the treatment. Choice B, serum potassium, is not directly affected by filgrastim therapy. Choice C, hemoglobin level, is important but not the primary indicator of filgrastim's effectiveness. Choice D, serum creatinine, is unrelated to the action of filgrastim and would not reflect its effectiveness.

2. Which nursing intervention is best for a client with constipation?

• A. Encourage the client to remain in bed to avoid straining
• B. Administer a stool softener as prescribed
• C. Increase fiber intake through dietary changes
• D. Encourage regular exercise to promote bowel movement

Correct answer: C

Rationale: Increasing fiber intake is the most appropriate nursing intervention for a client experiencing constipation. Fiber helps add bulk to the stool, making it easier to pass and promoting regular bowel movements. Encouraging the client to remain in bed may exacerbate constipation by reducing movement and promoting inactivity. While stool softeners can be beneficial, they are typically used as a short-term solution and may not address the underlying issue of low fiber intake. Regular exercise is important for overall bowel health; however, in the immediate management of constipation, increasing fiber intake is the most effective intervention.

3. A nurse is observing an assistive personnel (AP) caring for a client. For which of the following actions by the AP should the nurse intervene?

• A. Providing care in the hallway
• B. Reporting client information in the hallway
• C. Helping another client use the restroom
• D. Feeding the client too quickly

Correct answer: B

Rationale: The correct answer is B because reporting client information in the hallway violates privacy regulations, compromising patient confidentiality. Providing care in the hallway (choice A) may not be ideal but is not a direct violation. Helping another client use the restroom (choice C) shows the AP's willingness to assist but is not a concern unless it compromises the current client's safety. Feeding the client too quickly (choice D) is a potential concern for aspiration but may not require immediate intervention as addressing hydration and swallowing strategies can help prevent complications.

4. What are the risk factors for the development of pressure ulcers, and how can they be prevented?

• A. Immobility and poor nutrition
• B. Increased mobility and proper hygiene
• C. Excess moisture and lack of movement
• D. Frequent turning and repositioning

Correct answer: A

Rationale: The correct answer is A: Immobility and poor nutrition are significant risk factors for pressure ulcers. Immobility leads to prolonged pressure on certain body areas, increasing the risk of tissue damage. Poor nutrition can impair skin integrity and the body's ability to heal. Prevention strategies include frequent turning and repositioning to relieve pressure points. Choice B is incorrect because increased mobility actually reduces the risk of pressure ulcers. Choice C is incorrect as excess moisture can contribute to skin breakdown, but it is not a primary risk factor. Choice D is incorrect as frequent turning and repositioning are part of the prevention measures, not risk factors.

5. How should a healthcare provider manage a patient with hyperkalemia?

• A. Administer insulin and glucose
• B. Restrict potassium intake
• C. Monitor ECG
• D. All of the above

Correct answer: D

Rationale: In managing hyperkalemia, it is essential to administer insulin and glucose to shift potassium into the cells, restrict potassium intake to prevent further elevation of serum levels, and monitor the ECG for signs of potassium-induced cardiac effects. Therefore, the correct answer is D, as all of the provided actions are important in the management of hyperkalemia. Choice A alone is not sufficient as it only addresses shifting potassium intracellularly without preventing further elevation. Choice B alone is not enough as it does not address the immediate need to lower serum potassium levels. Choice C alone is insufficient as it only monitors for cardiac effects without addressing potassium levels or shifting mechanisms.

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