Nursing Elites

1. A healthcare professional is reviewing the medical record of a client scheduled for a CT scan with contrast media. The healthcare professional should identify which of the following findings as a contraindication to the procedure?

• A. White blood cell count of 6,000/mm³
• B. Urine specific gravity of 1.025
• C. History of asthma
• D. History of allergy to shellfish

Correct answer: D

Rationale: The correct answer is D, a history of allergy to shellfish. A known allergy to shellfish is a contraindication for the use of contrast media in a CT scan due to the potential risk of an allergic reaction, which could be severe and life-threatening. Choices A, B, and C are not contraindications to the procedure. A normal white blood cell count, urine specific gravity within the normal range, and a history of asthma do not typically interfere with the administration of contrast media for a CT scan.

2. What is the appropriate nursing action for a patient experiencing an acute allergic reaction?

• A. Administer antihistamines
• B. Administer corticosteroids
• C. Administer oxygen
• D. Administer bronchodilators

Correct answer: A

Rationale: The appropriate nursing action for a patient experiencing an acute allergic reaction is to administer antihistamines. Antihistamines work by blocking the action of histamine, a chemical released during an allergic reaction, and can help relieve symptoms such as itching, swelling, and hives. Corticosteroids are used for severe allergic reactions not responding to antihistamines, as they have anti-inflammatory properties. Oxygen is administered in cases of respiratory distress, while bronchodilators are used for bronchospasms. However, the first-line intervention for an acute allergic reaction is antihistamines.

3. A nurse is planning care for a client who has unilateral paralysis and dysphagia following a right hemispheric stroke. Which of the following interventions should the nurse include in the plan?

• A. Place food on the left side of the client's mouth when they are ready to eat
• B. Provide assistance with the client's ADLs
• C. Maintain the client in an upright position
• D. Place the client's left arm on a pillow while they are sitting

Correct answer: D

Rationale: Placing the client's left arm on a pillow while they are sitting helps prevent shoulder displacement and provides support for the limb post-stroke. This positioning is important to maintain proper alignment and prevent complications. Choices A, B, and C are incorrect because placing food on the left side of the mouth, providing total assistance with ADLs, and maintaining the client on bed rest do not directly address the specific needs related to unilateral paralysis and dysphagia post right hemispheric stroke.

4. Which electrolyte imbalance is most common in patients receiving furosemide?

• A. Hypokalemia
• B. Hypercalcemia
• C. Hyponatremia
• D. Hyperkalemia

Correct answer: A

Rationale: The correct answer is A, Hypokalemia. Furosemide, a loop diuretic, commonly leads to potassium loss in the urine, causing hypokalemia. This electrolyte imbalance should be closely monitored in patients taking furosemide. Choices B, C, and D are incorrect because hypercalcemia, hyponatremia, and hyperkalemia are not typically associated with furosemide use.

5. A client who is 2 hours postoperative following a kidney biopsy is being assessed by a nurse. Which of the following findings should the nurse report to the provider?

• A. Urinary output of 30 mL/hr.
• B. Hemoglobin 10 g/dL.
• C. Respiratory rate of 16/min.
• D. Blood pressure 110/70 mm Hg.

Correct answer: B

Rationale: The correct answer is B. A hemoglobin level of 10 g/dL is below the normal range and should be reported following a kidney biopsy to check for bleeding. Decreased hemoglobin levels could indicate internal bleeding, which is a significant concern postoperatively. Choices A, C, and D are within normal limits and do not require immediate reporting. Urinary output of 30 mL/hr is also within the acceptable range for a postoperative client. A respiratory rate of 16/min and blood pressure of 110/70 mm Hg are both normal findings postoperatively.

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