Nursing Elites

1. A nurse is reviewing the laboratory results of a client who has hypocalcemia. Which of the following findings should the nurse expect?

• A. Positive Trousseau's sign
• B. Increased deep tendon reflexes
• C. Hyperactive bowel sounds
• D. Weak, thready pulse

Correct answer: A

Rationale: A positive Trousseau's sign is a key finding in clients with hypocalcemia, indicating neuromuscular irritability. The other choices are not typically associated with hypocalcemia. Increased deep tendon reflexes are more indicative of hypercalcemia. Hyperactive bowel sounds can be seen in hyperactive bowel conditions or diarrhea, not specifically related to hypocalcemia. A weak, thready pulse may indicate cardiovascular issues, such as dehydration, but it is not a typical finding in hypocalcemia.

2. A nurse is reviewing the medical record of a client with major depressive disorder who is taking fluoxetine. Which of the following findings should the nurse report to the provider?

• A. Heart rate of 80/min
• B. Blood pressure 130/80 mm Hg
• C. Weight gain of 2.2 kg (5 lb) in 1 week
• D. Temperature of 37.2°C (99°F)

Correct answer: C

Rationale: The correct answer is C. A weight gain of 2.2 kg (5 lb) in 1 week can indicate fluid retention, a serious side effect of fluoxetine that should be reported to the provider. Choices A, B, and D are within normal ranges and are not alarming findings that would require immediate reporting to the provider. A heart rate of 80/min, blood pressure of 130/80 mm Hg, and a temperature of 37.2°C (99°F) are all within normal limits and not typically concerning in a client taking fluoxetine.

3. A healthcare provider is providing discharge instructions to a client who has a new prescription for metformin. Which of the following instructions should the healthcare provider include?

• A. Take this medication with meals.
• B. Avoid consuming alcohol while taking this medication.
• C. Take this medication at bedtime.
• D. Report any muscle pain to your healthcare provider.

Correct answer: B

Rationale: The correct answer is B: 'Avoid consuming alcohol while taking this medication.' Clients taking metformin should avoid alcohol as it increases the risk of lactic acidosis. Choice A is incorrect because metformin is usually taken with meals to reduce gastrointestinal side effects. Choice C is incorrect as metformin is typically taken with meals, not at bedtime. Choice D is incorrect because muscle pain is not a common side effect of metformin.

4. A healthcare provider is assisting with mass casualty triage following an explosion at a local factory. Which of the following clients should the healthcare provider identify as the priority?

• A. A client who has massive head trauma
• B. A client who has full-thickness burns to the face and trunk
• C. A client with indications of hypovolemic shock
• D. A client with an open fracture of the lower extremity

Correct answer: C

Rationale: In a mass casualty situation, a client with hypovolemic shock should be the priority as they require immediate intervention to restore fluid volume and prevent further deterioration. Hypovolemic shock can lead to organ failure and death if not addressed promptly. While clients with other severe conditions like massive head trauma, full-thickness burns, or an open fracture also need urgent care, hypovolemic shock directly threatens the client's life due to inadequate circulating blood volume. Therefore, stabilizing the client with indications of hypovolemic shock takes precedence over others in this scenario.

5. A nurse is reviewing the laboratory results of a client who has Cushing's disease. The nurse should expect an increase in which of the following laboratory values?

• A. Serum glucose level
• B. Serum potassium level
• C. Serum calcium level
• D. Serum sodium level

Correct answer: A

Rationale: The correct answer is A: Serum glucose level. In Cushing's disease, there is increased cortisol production, leading to elevated blood glucose levels. This occurs due to the role of cortisol in promoting gluconeogenesis and insulin resistance. Choices B, C, and D are incorrect because Cushing's disease is not typically associated with alterations in serum potassium, calcium, or sodium levels.

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