Nursing Elites

1. A nurse reviews a client's laboratory report and notes that the client's serum phosphorus level is 2.0 mg/dL. Which condition most likely caused this serum phosphorus level?

• A. Alcoholism
• B. Renal insufficiency
• C. Hypoparathyroidism
• D. Tumor lysis syndrome

Correct answer: A

Rationale: The correct answer is A: Alcoholism. Alcoholism can lead to hypophosphatemia due to poor dietary intake and other factors. Excessive alcohol consumption can result in malnutrition, particularly a deficiency in phosphorus. Choices B, C, and D are unlikely to cause low serum phosphorus levels. Renal insufficiency is more likely to cause hyperphosphatemia, hypoparathyroidism is associated with hypocalcemia rather than hypophosphatemia, and tumor lysis syndrome typically presents with hyperphosphatemia due to the release of intracellular phosphate.

2. Which of the following nursing interventions should be taken for a client who complains of nausea and vomits one hour after taking his glyburide (DiaBeta)?

• A. Administer glyburide again
• B. Administer subcutaneous insulin and monitor blood glucose
• C. Monitor blood glucose closely, and look for signs of hypoglycemia
• D. Monitor blood glucose and assess for signs of hyperglycemia

Correct answer: C

Rationale: After a client complains of nausea and vomits one hour after taking glyburide, the priority nursing intervention should be to monitor blood glucose closely and look for signs of hypoglycemia. Vomiting could indicate that the glyburide was not properly absorbed, potentially leading to hypoglycemia. Administering glyburide again (Choice A) could worsen hypoglycemia. Administering subcutaneous insulin (Choice B) is not appropriate without assessing the blood glucose first. Monitoring for signs of hyperglycemia (Choice D) is not the immediate concern in this situation.

3. When a woman has miscarried in three or more consecutive pregnancies, it is referred to as which type of spontaneous abortion?

• A. Inevitable
• B. Missed
• C. Habitual
• D. Threatened

Correct answer: C

Rationale: The correct answer is C, 'Habitual.' Habitual abortion is defined as three or more consecutive miscarriages, making it the appropriate term for this situation. Choice A, 'Inevitable,' refers to a miscarriage that cannot be prevented. Choice B, 'Missed,' refers to a miscarriage where the fetus has died but has not been expelled. Choice D, 'Threatened,' refers to a situation where there is bleeding in early pregnancy but the cervix remains closed.

4. What is an episiotomy?

• A. A surgical incision of the perineum to prevent tearing during delivery.
• B. Releasing the red plug from the cervix just before crowning occurs.
• C. An incision in the abdomen with which the baby can be delivered through.
• D. The severance of the umbilical cord between mother and child.

Correct answer: A

Rationale: An episiotomy is a surgical incision of the perineum to prevent tearing during delivery. This procedure is performed to widen the vaginal opening and facilitate childbirth. Choice B is incorrect as it describes the expulsion of the mucus plug, not an episiotomy. Choice C is incorrect as it refers to a different procedure, a cesarean section, where the baby is delivered through an incision in the abdomen. Choice D is incorrect as it pertains to cutting the umbilical cord, which is not related to an episiotomy.

5. A client is preparing for an elective mastectomy. The client is wearing a plain gold wedding band. Which of the following is an appropriate procedure for taking care of this client's ring?

• A. Agree to keep the ring for the client until after surgery
• B. Place the ring in the bag with the client's clothing
• C. Tape the ring securely to the client's finger
• D. Place the client's ring in the facility safe

Correct answer: D

Rationale: In this scenario, placing the client's ring in the facility safe is the most appropriate procedure. This ensures the ring is kept secure and prevents any risk of loss or damage during the surgery. Agreeing to keep the ring for the client could raise concerns about accountability, while placing it in the bag with the client's clothing might lead to misplacement. Taping the ring securely to the client's finger is not recommended as it may hinder blood circulation or cause discomfort.

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