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. What is the best position for a patient with respiratory distress?

• A. Semi-Fowler's position
• B. Trendelenburg position
• C. Prone position
• D. Supine position

Correct answer: A

Rationale: The best position for a patient with respiratory distress is the Semi-Fowler's position. This position promotes lung expansion and improves oxygenation by allowing the chest to expand more fully. The Trendelenburg position, where the patient's feet are higher than the head, is contraindicated in respiratory distress as it can increase pressure on the diaphragm and compromise breathing. The prone position, lying face down, may be beneficial in certain cases like acute respiratory distress syndrome but is not generally recommended for all patients in respiratory distress. The supine position, lying flat on the back, can worsen respiratory distress by causing the tongue to fall back and obstruct the airway.

3. A nurse is reviewing the medical record of a client who has a new prescription for insulin glargine. Which of the following should the nurse include in the teaching?

• A. This insulin has a peak effect of 2 to 4 hours.
• B. This insulin has a duration of action of 24 hours.
• C. This insulin is given before meals to control your blood sugar.
• D. You should avoid eating 30 minutes before or after taking this insulin.

Correct answer: B

Rationale: The correct answer is B. Insulin glargine has a 24-hour duration of action, making it suitable for once-daily dosing for long-term blood sugar control. Choice A is incorrect as insulin glargine is a long-acting insulin with no pronounced peak effect in its action profile. Choice C is incorrect as insulin glargine is usually given at the same time each day regardless of meals. Choice D is incorrect as there is no specific requirement to avoid eating before or after taking insulin glargine.

4. During an in-service about nursing leadership, what information should the nurse include about an effective leader?

• A. Acts as an advocate for the nursing unit.
• B. Prioritizes staff requests over client needs.
• C. Shares personal opinions to influence the group's values.
• D. Provides routine client care and documentation.

Correct answer: A

Rationale: An effective leader advocates for the unit's success and its members. Choice B is incorrect because prioritizing staff requests over client needs does not align with effective leadership, which should focus on client-centered care. Choice C is incorrect as sharing personal opinions to influence the group's values can be biased and may not reflect the best interest of the team. Choice D is incorrect because while providing client care is essential, effective leadership involves more than routine tasks and includes guiding and supporting the team.

5. A nurse is caring for a client who is in labor and requires augmentation of labor. Which of the following conditions should the nurse recognize as a contraindication to the use of oxytocin?

• A. Diabetes mellitus
• B. Shoulder presentation
• C. Postterm with oligohydramnios
• D. Chorioamnionitis

Correct answer: B

Rationale: Shoulder presentation is a contraindication for oxytocin because it can increase the risk of complications during labor, such as shoulder dystocia. Diabetes mellitus (Choice A) is not a contraindication for the use of oxytocin. Postterm with oligohydramnios (Choice C) and chorioamnionitis (Choice D) may actually necessitate the use of oxytocin to induce or augment labor for the well-being of the mother and baby.

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