Nursing Elites

1. A healthcare professional is reviewing the laboratory values of a client who is experiencing fluid volume deficit (FVD). What finding should the professional expect?

• A. Decreased hematocrit
• B. Increased hematocrit
• C. Decreased white blood cell count
• D. Increased red blood cell count

Correct answer: B

Rationale: The correct answer is 'Increased hematocrit.' In fluid volume deficit (FVD), there is a decrease in the amount of fluid in the blood vessels, leading to hemoconcentration. This results in an increase in hematocrit levels. Choices A, C, and D are incorrect because a decrease in hematocrit, decrease in white blood cell count, and an increase in red blood cell count are not typically seen in fluid volume deficit.

2. A healthcare professional is preparing to administer multiple medications to a client with dysphagia. What action should the healthcare professional take?

• A. Offer the medications with a full glass of water
• B. Crush the medications and mix them together
• C. Provide the medications through a straw
• D. Mix the medications with applesauce

Correct answer: C

Rationale: Clients with dysphagia have difficulty swallowing, so providing medications through a straw can help control the flow and prevent aspiration. Offering medications with a full glass of water (Choice A) may increase the risk of aspiration. Crushing medications and mixing them together (Choice B) can alter the medication's effectiveness or cause adverse effects. Mixing medications with applesauce (Choice D) may also present a choking hazard for clients with dysphagia.

3. A nurse is caring for a client who has a prescription for a narcotic medication. What should the nurse do with the unused portion after administration?

• A. Store it in the medication cart for later use
• B. Discard it with a witness present
• C. Return it to the pharmacy
• D. Report it to the provider

Correct answer: B

Rationale: The correct action for the nurse to take with the unused portion of a narcotic medication after administration is to discard it with a witness present. This procedure is necessary to comply with controlled substance regulations and prevent diversion or misuse of the medication. Storing it in the medication cart for later use is inappropriate as it can lead to unauthorized access. Returning it to the pharmacy is not recommended as the medication has already been dispensed. Reporting it to the provider is not the standard procedure for disposing of controlled substances.

4. A nurse is updating a plan of care for a client who has dysphagia. What intervention should the nurse include?

• A. Encourage the client to lie down after eating
• B. Offer the client liquids with meals
• C. Have the client sit upright for 1 hour after meals
• D. Provide the client with a straw for drinking

Correct answer: C

Rationale: The correct intervention for a client with dysphagia is to have them sit upright for 1 hour after meals. This position helps facilitate swallowing and reduces the risk of aspiration, which is crucial in managing dysphagia. Encouraging the client to lie down after eating (Choice A) can increase the risk of aspiration. Offering liquids with meals (Choice B) may also increase the risk of aspiration as it can affect swallowing coordination. Providing the client with a straw for drinking (Choice D) is not recommended as straws can increase the risk of aspiration in individuals with dysphagia.

5. During a focused assessment for a client with dysrhythmias, what indicates ineffective cardiac contractions?

• A. Increased heart rate
• B. Pulse deficit
• C. Elevated blood pressure
• D. Bounding pulse

Correct answer: B

Rationale: A pulse deficit is a crucial finding in clients with dysrhythmias as it indicates ineffective cardiac contractions. A pulse deficit occurs when the apical heart rate is faster than the radial pulse rate, suggesting that some heartbeats are not generating a pulse. This can be a sign of serious heart conditions like atrial fibrillation or heart failure. The other options, such as an increased heart rate (choice A), elevated blood pressure (choice C), and bounding pulse (choice D), do not specifically indicate ineffective cardiac contractions and are not directly associated with dysrhythmias.

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