Nursing Elites

1. A nurse is reviewing the laboratory results for a client who is at 29 weeks of gestation. Which of the following results should the nurse report to the provider?

• A. WBC count 11,000/mm³
• B. Hgb 11.2 g/dL
• C. Hct 34%
• D. Platelets 140,000/mm³

Correct answer: D

Rationale: A platelet count of 140,000/mm³ is at the lower end of the normal range but can be concerning in pregnancy, especially if there are signs of thrombocytopenia or bleeding. Thrombocytopenia in pregnancy can lead to complications such as bleeding during childbirth or excessive bleeding postpartum. The other laboratory values mentioned are within normal ranges for pregnancy and do not typically raise immediate concerns. High WBC counts can be a normal response to pregnancy, hemoglobin levels around 11.2 g/dL and hematocrit levels around 34% are also considered normal in the third trimester.

2. A client is receiving magnesium sulfate for preeclampsia. Which finding indicates magnesium toxicity?

• A. Respiratory rate of 12/min
• B. Diminished deep tendon reflexes
• C. Urine output 40 mL/hr
• D. Systolic blood pressure of 140 mm Hg

Correct answer: B

Rationale: Diminished deep tendon reflexes are a sign of magnesium toxicity. Magnesium sulfate can depress the central nervous system, leading to decreased reflexes. Respiratory rate of 12/min, urine output 40 mL/hr, and systolic blood pressure of 140 mm Hg are not specific findings of magnesium toxicity. Respiratory depression, oliguria, and hypotension are more concerning signs that require immediate attention.

3. A nurse is preparing to administer a dose of insulin. Which of the following should the nurse do first?

• A. Check the expiration date
• B. Verify the client's blood glucose level
• C. Obtain the client's weight
• D. Assess for signs of hypoglycemia

Correct answer: B

Rationale: The correct answer is to verify the client's blood glucose level first before administering insulin. This step is crucial to determine the appropriate dose of insulin based on the client's current blood glucose level. Checking the expiration date (Choice A) is important but not the first step in this scenario. Obtaining the client's weight (Choice C) is not directly related to the immediate administration of insulin. Assessing for signs of hypoglycemia (Choice D) should be done after administering insulin to monitor for potential side effects or adverse reactions.

4. A healthcare professional is preparing to administer heparin 8,000 units subcutaneously every eight hrs. The amount available is heparin injection 10,000 units/mL. How many milliliters should the healthcare professional administer per dose?

• A. 0.7 mL
• B. 0.8 mL
• C. 1.0 mL
• D. 1.2 mL

Correct answer: B

Rationale: Calculation: 8000 units / 10,000 units per mL = 0.8 mL. To correctly administer the prescribed dose of 8000 units, the healthcare professional should draw up 0.8 mL from the 10,000 units/mL vial. Options A, C, and D are incorrect as they do not accurately reflect the calculation based on the available concentration of heparin.

5. A client with a new prescription for an albuterol metered-dose inhaler is being taught by a nurse. Which of the following instructions should the nurse include in the teaching?

• A. Inhale quickly when using the inhaler.
• B. Hold your breath for 10 seconds after inhaling the medication.
• C. Take a second puff of the inhaler immediately after the first.
• D. Exhale fully after using the inhaler.

Correct answer: B

Rationale: The correct instruction is to hold your breath for 10 seconds after inhaling the medication. This allows the medication to settle in the lungs and maximize its effectiveness. Choice A is incorrect as inhaling quickly may lead to improper medication delivery. Choice C is wrong because taking a second puff immediately after the first without waiting for the prescribed interval may cause an overdose. Choice D is also incorrect as exhaling fully after using the inhaler may result in the medication being exhaled rather than absorbed by the lungs.

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