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 assessing a client who has chronic kidney disease. Which of the following findings should the healthcare professional report to the provider?

• A. Urine output of 80 mL/hr
• B. Blood pressure of 140/90 mm Hg
• C. Serum creatinine 2.8 mg/dL
• D. Heart rate of 72/min

Correct answer: C

Rationale: The correct answer is C. A serum creatinine level of 2.8 mg/dL indicates impaired kidney function and should be reported to the healthcare provider. Elevated serum creatinine levels are indicative of decreased kidney function and potential progression of chronic kidney disease. Choices A, B, and D are within normal ranges and do not signify immediate concerns related to kidney disease. Urine output of 80 mL/hr is appropriate, a blood pressure of 140/90 mm Hg is considered prehypertensive but not acutely concerning, and a heart rate of 72/min falls within the normal range.

3. A nurse is reviewing the laboratory results of a client who has hypokalemia. Which of the following findings should the nurse expect?

• A. Serum potassium 5.4 mEq/L
• B. Flat T waves
• C. Elevated ST segments
• D. Bradycardia

Correct answer: B

Rationale: Flat T waves are a characteristic ECG finding in hypokalemia. Hypokalemia causes a decrease in serum potassium levels, leading to altered cardiac conduction. Flat T waves are associated with hypokalemia-induced cardiac dysrhythmias. Elevated ST segments are typically seen in conditions like myocardial infarction, not in hypokalemia. Bradycardia is not a typical manifestation of hypokalemia; instead, tachycardia may occur due to potassium imbalances affecting the heart's electrical activity.

4. A nurse is caring for a client with schizophrenia. Which of the following assessment findings should the nurse expect?

• A. Decreased level of consciousness
• B. Inability to identify common objects
• C. Poor problem-solving ability
• D. Preoccupation with somatic disturbances

Correct answer: B

Rationale: In schizophrenia, clients often display an inability to identify common objects due to cognitive impairment. This is known as associative agnosia, where individuals struggle to recognize familiar objects, faces, or sounds. Choices A, C, and D are not typically associated with schizophrenia. Decreased level of consciousness is more indicative of conditions like head trauma or drug overdose. Poor problem-solving ability may be seen in various mental health disorders but is not specific to schizophrenia. Preoccupation with somatic disturbances is more commonly seen in somatic symptom disorders or somatic delusions, not a typical finding in schizophrenia.

5. A client with asthma is being taught how to use a peak flow meter by a nurse. Which of the following instructions should the nurse include?

• A. Blow as hard as possible into the mouthpiece.
• B. Exhale quickly and forcefully after taking a deep breath.
• C. Inhale as deeply as possible and then blow into the mouthpiece.
• D. Take a deep breath and hold it for 5 seconds before exhaling.

Correct answer: B

Rationale: The correct answer is B because the client should exhale quickly and forcefully into the peak flow meter after taking a deep breath to measure peak expiratory flow. Choice A is incorrect as blowing as hard as possible may not provide an accurate reading. Choice C is incorrect because inhaling deeply before blowing can affect the results. Choice D is incorrect as holding the breath before exhaling is not part of using a peak flow meter.

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