Nursing Elites

1. A nurse is sitting with the partner of a client who recently died. Which of the following actions should the nurse take to facilitate mourning?

• A. Encourage the partner to ask for help when needed
• B. Suggest the partner avoid discussing their feelings
• C. Recommend immediate return to daily activities
• D. Advise the partner to remain strong

Correct answer: A

Rationale: The correct action for the nurse to take to facilitate mourning is to encourage the partner to ask for help when needed. Grieving is a challenging process, and offering support and encouragement to seek help can be beneficial. Choice B is incorrect because avoiding discussing feelings can hinder the grieving process by suppressing emotions. Choice C is also incorrect as an immediate return to daily activities may not allow the partner to properly process their grief. Choice D is not the best approach as advising the partner to 'remain strong' may discourage the expression of emotions and seeking support, which are essential in the mourning process.

2. Using Naegele's Rule, what is the estimated delivery date for a pregnant client whose last menstrual period was on May 4th, 2013?

• A. January 15, 2014
• B. February 11, 2014
• C. March 3, 2014
• D. December 25, 2013

Correct answer: B

Rationale: Naegele's rule is a standard method for calculating the estimated delivery date (EDD). It involves subtracting three months from the first day of the last menstrual period (LMP), adding seven days, and then adding one year. For a client with an LMP of May 4th, 2013, subtracting three months gives February 4th. Adding seven days results in a due date of February 11th, 2014, which is the correct answer. Choice A (January 15, 2014) is incorrect as it does not account for the full calculation. Choice C (March 3, 2014) is incorrect as it adds too many days in the calculation. Choice D (December 25, 2013) is incorrect as it does not follow the correct steps of Naegele's rule.

3. A nurse is planning care for four clients. Which client is the highest priority?

• A. Client with dry, black eschar on the heel
• B. Client wearing an arm cast and reporting numb fingers
• C. Client with reddened skin around the coccyx
• D. Client with frequent incontinence

Correct answer: B

Rationale: The correct answer is B because numb fingers indicate neurovascular compromise, which can lead to serious complications if not addressed promptly. The priority in this situation is to assess and address any circulation issues affecting the extremity. Choices A, C, and D are of concern but not as immediate as neurovascular compromise, which requires urgent attention to prevent further complications.

4. A nurse is caring for a client who has acute pancreatitis. Which of the following laboratory findings should the nurse expect?

• A. Decreased serum amylase
• B. Decreased serum lipase
• C. Elevated blood glucose
• D. Elevated calcium levels

Correct answer: C

Rationale: In acute pancreatitis, the nurse should expect elevated blood glucose levels. This is due to impaired insulin production by the inflamed pancreas. While serum amylase and lipase levels are typically elevated in acute pancreatitis, blood glucose levels are also affected due to the pancreatic dysfunction. Therefore, choices A and B are incorrect. Elevated calcium levels are not typically associated with acute pancreatitis, making choice D incorrect.

5. A postpartum client's fundus is firm, 3 cm above the umbilicus, and displaced to the right. Which of the following interventions should the nurse take?

• A. Massage the fundus
• B. Administer oxytocin
• C. Assist the client to void then reassess the fundus
• D. Notify the healthcare provider

Correct answer: C

Rationale: The correct intervention for a postpartum client with a firm, displaced fundus is to assist the client to void then reassess the fundus. Displacement of the uterus to the right is often a sign of bladder distention, which can prevent the uterus from contracting properly and increase the risk of postpartum hemorrhage. By helping the client to void, the nurse can alleviate the bladder distention, allowing the uterus to contract effectively. Massaging the fundus (Choice A) may not address the underlying issue of bladder distention. Administering oxytocin (Choice B) is not indicated without assessing and addressing the cause of the displacement. Notifying the healthcare provider (Choice D) is premature before implementing initial nursing interventions to address the potential cause of the displaced fundus.

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