Nursing Elites

1. A healthcare professional is reviewing the laboratory results of a client who is receiving chemotherapy. Which of the following findings should the healthcare professional report immediately?

• A. White blood cell count of 4,500/mm³
• B. Hemoglobin level of 8 g/dL
• C. Platelet count of 90,000/mm³
• D. Serum potassium level of 3.5 mEq/L

Correct answer: C

Rationale: A platelet count of 90,000/mm³ indicates thrombocytopenia, which increases the risk of bleeding and requires immediate intervention. Thrombocytopenia can lead to serious bleeding complications, so it is crucial to address this finding promptly. A low white blood cell count (choice A) may indicate neutropenia but is not as immediately life-threatening as severe thrombocytopenia. A hemoglobin level of 8 g/dL (choice B) would require intervention but is not as urgent as addressing a critically low platelet count. A serum potassium level of 3.5 mEq/L (choice D) is on the lower side of normal but does not pose an immediate risk to the client's safety compared to severe thrombocytopenia.

2. A client has a new prescription for nitroglycerin sublingual tablets. Which of the following instructions should the nurse include?

• A. You should lie down before taking this medication.
• B. You should take this medication on an empty stomach.
• C. You should never take a double dose if you miss one.
• D. You should store this medication in its original container at room temperature.

Correct answer: A

Rationale: The correct instruction for a client prescribed nitroglycerin sublingual tablets is to lie down before taking the medication. Nitroglycerin can cause a sudden drop in blood pressure leading to dizziness or fainting, so taking the medication while lying down helps prevent falls. Choice B is incorrect because nitroglycerin is usually taken on an empty stomach to enhance its absorption. Choice C is incorrect as taking a double dose of nitroglycerin can lead to low blood pressure and other adverse effects. Choice D is incorrect as nitroglycerin sublingual tablets should be stored in their original container at room temperature away from light and moisture, not in the refrigerator.

3. A nurse is caring for a client who is at risk for developing deep vein thrombosis (DVT). Which of the following interventions should the nurse implement?

• A. Massage the client's legs every 4 hours.
• B. Administer prophylactic antibiotics.
• C. Apply sequential compression devices to the client's legs.
• D. Encourage the client to remain on bed rest.

Correct answer: C

Rationale: Applying sequential compression devices is the appropriate intervention for a client at risk for developing deep vein thrombosis (DVT). This intervention helps prevent venous stasis by promoting circulation in the lower extremities, reducing the risk of DVT. Massaging the client's legs every 4 hours is contraindicated as it can dislodge a blood clot and increase the risk of embolism. Administering prophylactic antibiotics is not indicated for preventing DVT. Encouraging the client to remain on bed rest can contribute to venous stasis and increase the risk of developing DVT.

4. A client is immediately postoperative following a hip arthroplasty. Which of the following positions should the nurse maintain for the client?

• A. Supine with legs extended
• B. Semi-Fowler's position with legs bent
• C. Lateral position with an abduction pillow between the legs
• D. Prone with legs elevated

Correct answer: C

Rationale: The correct position for a client immediately postoperative following a hip arthroplasty is the lateral position with an abduction pillow between the legs. This position helps prevent dislocation of the hip prosthesis and maintains proper alignment of the hip joint. Supine position with legs extended (Choice A) may put stress on the hip joint, Semi-Fowler's position with legs bent (Choice B) may not provide adequate support and alignment, and prone position with legs elevated (Choice D) is not recommended after hip arthroplasty as it can compromise the surgical site and increase the risk of complications.

5. A nurse is caring for a client who has a pulmonary embolism. Which of the following findings indicates the effectiveness of the treatment?

• A. A chest x-ray reveals increased density in all lung fields.
• B. The client reports feeling less anxious.
• C. Diminished breath sounds are auscultated bilaterally.
• D. ABG results include pH 7.48, PaO2 77 mm Hg, and PaCO2 47 mm Hg.

Correct answer: B

Rationale: The correct answer is B. In a client with a pulmonary embolism, improvement in anxiety levels can indicate the effectiveness of treatment as it suggests better oxygenation and perfusion. Choices A, C, and D do not directly reflect the effectiveness of treatment for a pulmonary embolism. Increased density in all lung fields on a chest x-ray may indicate worsening of the condition, diminished breath sounds suggest impaired lung function, and ABG results with a pH of 7.48, PaO2 of 77 mm Hg, and PaCO2 of 47 mm Hg do not specifically indicate treatment effectiveness for a pulmonary embolism.

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