Nursing Elites

1. A nurse is reviewing the laboratory results of a client who is at 36 weeks of gestation. The nurse should report which of the following laboratory results to the provider?

• A. Hemoglobin 11.2 g/dL
• B. Platelet count 148,000/mm3
• C. Leukocyte count 9,000/mm3
• D. Blood glucose 80 mg/dL

Correct answer: A

Rationale: A hemoglobin level of 11.2 g/dL is below the normal range for a client who is 36 weeks gestation and should be reported to the provider.

2. A client who is postoperative following a total hip arthroplasty is at risk for hip dislocation. Which of the following actions should the nurse take to prevent this complication?

• A. Position the client supine with a pillow between the legs
• B. Place a pillow under the client's knees
• C. Place an abduction pillow between the client's legs
• D. Place a trochanter roll under the client's legs

Correct answer: C

Rationale: After a total hip arthroplasty, it is crucial to prevent hip dislocation. Placing an abduction pillow between the client's legs helps maintain proper alignment and prevents the hip from dislocating. This position aids in keeping the hip in a neutral or slightly outwardly rotated position, reducing the risk of dislocation. Placing the client supine with a pillow between the legs (Choice A) or using a trochanter roll (Choice D) may not provide the same level of abduction and support needed to prevent hip dislocation. Placing a pillow under the client's knees (Choice B) does not provide the necessary support to maintain proper hip alignment in this situation.

3. A client receiving chemotherapy is being taught about infection prevention by a nurse. Which of the following instructions should the nurse include?

• A. Wear a mask when gardening.
• B. Avoid crowds to reduce the risk of infection.
• C. You should take a daily vitamin to prevent infection.
• D. Increase your intake of high-protein foods.

Correct answer: B

Rationale: The correct answer is B: 'Avoid crowds to reduce the risk of infection.' Clients receiving chemotherapy are immunocompromised, so avoiding crowds can help decrease the likelihood of exposure to infections. Wearing a mask when gardening (choice A) is important but not directly related to infection prevention in the context of chemotherapy. Taking a daily vitamin (choice C) may be beneficial for overall health but is not specifically focused on infection prevention. Increasing intake of high-protein foods (choice D) is essential for nutrition but does not directly address infection prevention.

4. A client with Parkinson's disease is receiving physical therapy. Which statement by the client indicates the need for a referral to physical therapy?

• A. I have been experiencing more tremors in my left arm than before
• B. I noticed that I am having a harder time holding onto my toothbrush
• C. Lately, I feel like my feet are freezing up, as they are stuck to the ground
• D. Sometimes, I feel I am making a chewing motion when I'm not eating

Correct answer: C

Rationale: The correct answer is C because freezing of feet while walking is a sign of impaired mobility, indicating the need for physical therapy in clients with Parkinson's disease. Choices A, B, and D are symptoms commonly associated with Parkinson's disease but do not specifically indicate the need for immediate referral to physical therapy.

5. A client who had a colon resection and a new ascending colostomy is receiving discharge teaching from a nurse. Which of the following statements by the client indicates an understanding of the teaching?

• A. My stool will become fully formed within 3 weeks.
• B. My skin should be cleaned with alcohol before applying a new pouch.
• C. I should avoid eating popcorn and fresh pineapple.
• D. I should expect bruising around the stoma.

Correct answer: C

Rationale: The correct answer is C because avoiding popcorn and fresh pineapple helps prevent complications with an ascending colostomy. Statements A, B, and D are incorrect. Statement A is inaccurate as it takes time for bowel function to normalize after surgery. Statement B is incorrect as alcohol can be irritating to the skin; gentle soap and water are recommended for cleaning. Statement D is incorrect as bruising around the stoma is not an expected outcome of colostomy creation.

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