Nursing Elites

1. A nurse is reviewing the medical record of a client who has a prescription for spironolactone. Which of the following findings should the nurse report to the provider?

• A. Potassium 5.0 mEq/L
• B. Blood pressure 136/84 mm Hg
• C. Sodium 140 mEq/L
• D. Calcium 9.5 mg/dL

Correct answer: A

Rationale: A potassium level of 5.0 mEq/L is at the upper limit of normal and should be monitored closely in clients taking spironolactone, which is potassium-sparing. Elevated potassium levels can lead to hyperkalemia, especially in individuals on potassium-sparing diuretics like spironolactone. Monitoring and reporting high potassium levels are crucial to prevent potential complications such as cardiac arrhythmias. Blood pressure (choice B), sodium level (choice C), and calcium level (choice D) are not directly related to the use of spironolactone and do not require immediate reporting in this scenario.

2. A client with a new diagnosis of peptic ulcer disease is receiving teaching from a nurse. Which of the following statements by the client indicates an understanding of the teaching?

• A. I will avoid taking ibuprofen for my pain.
• B. I will avoid eating spicy foods.
• C. I will limit my intake of dairy products.
• D. I will take my antacids 30 minutes before meals.

Correct answer: B

Rationale: The correct answer is B. Clients with peptic ulcer disease should avoid spicy foods as they can exacerbate symptoms and delay healing. Ibuprofen can worsen peptic ulcers by irritating the stomach lining, so it should be avoided. While limiting dairy products may be beneficial for some individuals with lactose intolerance, it is not a specific recommendation for peptic ulcer disease. Taking antacids before meals can help neutralize stomach acid; however, the timing may vary depending on the type of antacid, so there is no universal rule of taking antacids 30 minutes before meals. Choice A is incorrect because the client should avoid taking ibuprofen due to its potential to worsen peptic ulcers. Choice C is incorrect as there is no direct correlation between dairy product intake and peptic ulcer disease. Choice D is incorrect because the timing of antacid administration can vary and should be guided by specific recommendations.

3. A client with osteoporosis should be encouraged to perform which of the following interventions as part of the plan of care?

• A. Encourage the client to increase calcium intake.
• B. Apply heat to the affected joints to reduce stiffness.
• C. Encourage weight-bearing exercises to prevent bone loss.
• D. Limit fluid intake to prevent swelling.

Correct answer: C

Rationale: The correct answer is to encourage weight-bearing exercises to prevent bone loss in clients with osteoporosis. Weight-bearing exercises help to strengthen bones and reduce the risk of fractures. Increasing calcium intake (Choice A) is important for bone health but is not the priority intervention for preventing bone loss in osteoporosis. Applying heat to affected joints (Choice B) may help with stiffness but does not address the underlying bone loss in osteoporosis. Limiting fluid intake (Choice D) is not relevant to managing osteoporosis and preventing bone loss.

4. A nurse is caring for a client who is receiving chemotherapy. Which of the following findings should the nurse report to the provider?

• A. Alopecia
• B. Weight gain of 1 kg (2.2 lb) in 24 hours
• C. White blood cell count of 6,000/mm³
• D. Temperature of 37.2°C (99°F)

Correct answer: B

Rationale: The correct answer is B. A weight gain of 1 kg (2.2 lb) in 24 hours is concerning as it indicates fluid retention, which can be a sign of complications in clients receiving chemotherapy. Rapid weight gain can be associated with conditions like fluid overload or electrolyte imbalances, which need prompt medical attention. Choices A, C, and D are not typically immediate concerns related to chemotherapy. Alopecia (choice A) is a common side effect of chemotherapy, a white blood cell count of 6,000/mm³ (choice C) falls within the normal range, and a temperature of 37.2°C (99°F) (choice D) is slightly elevated but not a critical finding in this context.

5. A nurse is caring for a client who is 32 weeks pregnant and has cardiac disease. Which of the following positions should the nurse place the client in to promote optimal cardiac output?

• A. Semi-Fowler's
• B. Supine with head elevated
• C. Left lateral
• D. Right lateral

Correct answer: C

Rationale: The correct answer is C: Left lateral. Placing the client in the left lateral position helps promote optimal cardiac output during pregnancy by avoiding pressure on the vena cava. This position improves venous return to the heart and subsequently cardiac output. Option A, Semi-Fowler's position, may not be the best choice for a client with cardiac disease as it does not alleviate pressure on the vena cava. Option B, supine with head elevated, can also compress the vena cava, reducing cardiac output. Option D, right lateral position, does not provide the same benefits as the left lateral position for cardiac output during pregnancy.

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