Nursing Elites

1. A healthcare provider is reviewing the laboratory report of a client with a prescription for digoxin. Which result requires withholding the medication?

• A. Digoxin 0.8 ng/mL
• B. Sodium 145 mEq/L
• C. BUN 20 mg/dL
• D. Potassium 3.1 mEq/L

Correct answer: D

Rationale: The correct answer is D. A low potassium level (3.1 mEq/L) can increase the risk of digoxin toxicity. Hypokalemia can potentiate the effects of digoxin on the heart, leading to serious dysrhythmias. Choices A, B, and C are within normal ranges and do not indicate a need to withhold digoxin.

2. A nurse is observing bonding between a client and her newborn. Which of the following actions by the client requires the nurse to intervene?

• A. Holding the newborn in an en face position
• B. Asking the father to change the newborn's diaper
• C. Requesting the nurse to take the newborn to the nursery so she can rest
• D. Viewing the newborn's actions as uncooperative

Correct answer: D

Rationale: The correct answer is D because viewing the newborn's actions as uncooperative indicates a lack of bonding, which requires intervention. Choices A, B, and C all involve appropriate and caring actions by the client towards the newborn. Holding the newborn in an en face position promotes bonding, involving the father in caring for the newborn is beneficial for family involvement, and requesting rest by asking the nurse to take the newborn to the nursery is a responsible action to ensure both the client and the newborn get adequate rest.

3. A nurse is performing a dressing change for a client who has a sacral wound using negative pressure wound therapy. Which of the following actions should the nurse take first?

• A. Apply skin preparation to wound edges.
• B. Don sterile gloves.
• C. Normal saline
• D. Determine pain level.

Correct answer: D

Rationale: The correct answer is to determine the pain level first. Assessing the client's pain is crucial before any procedure to ensure their comfort and safety. Applying skin preparation to wound edges (Choice A) may come later in the process after ensuring the client's comfort. Donning sterile gloves (Choice B) is important before directly handling the wound but can follow pain assessment. Normal saline (Choice C) might be used during wound cleansing but is not the initial step in this situation.

4. A nurse is caring for a client who is 2 hours postoperative following a cholecystectomy. Which of the following actions should the nurse take to prevent postoperative complications?

• A. Instruct the client to perform deep breathing and coughing exercises.
• B. Have the client wear sequential compression devices (SCDs).
• C. Place the client in a supine position with the head of the bed flat.
• D. Encourage the client to ambulate every 2 hours.

Correct answer: B

Rationale: The correct answer is B: Have the client wear sequential compression devices (SCDs). Following a cholecystectomy, the client is at risk for venous thromboembolism (VTE) due to reduced mobility and surgical stress. SCDs help prevent VTE by promoting venous return and reducing the risk of blood clots. Choices A, C, and D are incorrect. While deep breathing and coughing exercises are essential postoperatively, SCDs take precedence in preventing VTE. Placing the client in a supine position with the head of the bed flat can increase the risk of respiratory complications. Encouraging ambulation is important, but SCDs are a higher priority in this situation to prevent VTE.

5. Which electrolyte imbalance is commonly associated with patients on furosemide?

• A. Hypokalemia
• B. Hyponatremia
• C. Hyperkalemia
• D. Hypercalcemia

Correct answer: A

Rationale: The correct answer is A: Hypokalemia. Furosemide, a loop diuretic, can lead to potassium loss in the body, resulting in hypokalemia. This electrolyte imbalance is commonly associated with furosemide use due to its mechanism of action in the kidneys. Hyponatremia (choice B) is not typically associated with furosemide. Hyperkalemia (choice C) and hypercalcemia (choice D) are not common electrolyte imbalances seen with furosemide use.

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