Nursing Elites

1. A nurse is reviewing the results of an arterial blood gas analysis of a client who has chronic obstructive pulmonary disease. Which of the following results should the nurse expect?

• A. PaO2 of 95 mm Hg
• B. PaCO2 of 55 mm Hg
• C. HCO3 of 24 mEq/L
• D. pH level of 7.35

Correct answer: B

Rationale: In chronic obstructive pulmonary disease, there is impaired gas exchange, leading to retention of carbon dioxide (CO2) and subsequent respiratory acidosis. A PaCO2 of 55 mm Hg is higher than the normal range (35-45 mm Hg) and is indicative of respiratory acidosis in COPD. Choices A, C, and D are not typically associated with COPD. PaO2 may be decreased, HCO3 may be elevated to compensate for acidosis, and pH may be lower than 7.35 due to respiratory acidosis in COPD.

2. A healthcare professional is reviewing the laboratory results of a client who has rheumatoid arthritis. Which of the following findings should be reported to the provider?

• A. WBC count 8,000/mm3
• B. Platelets 150,000/mm3
• C. Aspartate aminotransferase 10 units/L
• D. Erythrocyte sedimentation rate 75 mm/hr

Correct answer: D

Rationale: The correct answer is D. A high erythrocyte sedimentation rate (ESR) of 75 mm/hr indicates inflammation, which is common in rheumatoid arthritis. Elevated ESR levels are often seen in inflammatory conditions like rheumatoid arthritis. Options A, B, and C are within the normal range and are not typically indicative of active inflammation associated with rheumatoid arthritis. Therefore, the nurse should report the elevated ESR level to the provider for further evaluation and management.

3. A nurse is planning care for a client who has a closed head injury and has an intraventricular catheter. Which of the following interventions should the nurse include to reduce the risk for infection?

• A. Keep the head of the bed elevated to 30 degrees.
• B. Administer IV antibiotics prophylactically.
• C. Change the catheter insertion site every 24 hours.
• D. Monitor the insertion site for redness.

Correct answer: D

Rationale: The correct answer is to monitor the insertion site for redness. This intervention helps detect signs of infection early in clients with intraventricular catheters. Keeping the head of the bed elevated to 30 degrees is important for managing intracranial pressure but does not directly reduce the risk of infection. Administering IV antibiotics prophylactically is not recommended as a routine practice due to the risk of antibiotic resistance and should only be done based on culture results. Changing the catheter insertion site every 24 hours is unnecessary and increases the risk of introducing new pathogens.

4. A nurse is providing education to a client who is at 28 weeks gestation and has gestational diabetes mellitus. Which of the following statements should the nurse make?

• A. You will need to increase your protein intake during pregnancy.
• B. It is important to monitor your blood glucose levels closely.
• C. Gestational diabetes can increase the risk of developing type 2 diabetes later in life.
• D. You will need to avoid exercise while managing your blood sugar.

Correct answer: C

Rationale: The correct statement the nurse should make is that gestational diabetes can increase the risk of developing type 2 diabetes later in life. This information is crucial for the client's understanding of the potential long-term implications of gestational diabetes. Monitoring blood glucose levels closely (Choice B) is also important but does not address the long-term risk of developing type 2 diabetes. Choices A and D are incorrect as increasing protein intake during pregnancy and avoiding exercise are not recommended strategies for managing gestational diabetes.

5. Which of the following actions is appropriate when administering a blood transfusion?

• A. Verify patient identity
• B. Administer medication
• C. Monitor vital signs
• D. Start blood transfusion without verification

Correct answer: A

Rationale: Verifying the patient's identity is a critical step when administering a blood transfusion to ensure that the correct blood product is given to the right patient. This process helps prevent errors and enhances patient safety. Choice B, 'Administer medication,' is incorrect because the focus during a blood transfusion should be on ensuring the correct blood product is administered. Choice C, 'Monitor vital signs,' is also important but comes after verifying the patient's identity. Choice D, 'Start blood transfusion without verification,' is incorrect and unsafe as patient identification verification is essential prior to starting any medical procedure, especially one as important as a blood transfusion.

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