Nursing Elites

1. A patient's serum potassium level is 2.2 mEq/L. Which nursing action is the highest priority for this patient?

• A. Start oxygen at 2 L/min
• B. Initiate cardiac monitoring
• C. Initiate seizure precautions
• D. Keep the patient on bed rest

Correct answer: B

Rationale: The correct answer is to initiate cardiac monitoring. Severe hypokalemia can lead to life-threatening arrhythmias, making cardiac monitoring the priority to detect and manage any cardiac complications. Starting oxygen, seizure precautions, or bed rest are not the immediate priority actions for severe hypokalemia.

2. A nurse in the emergency department is preparing to care for a client who arrived via ambulance. The client is disoriented and has a cardiac arrhythmia. Which of the following actions should the nurse take?

• A. Proceed with treatment without obtaining written consent
• B. Contact the client's next of kin to obtain consent for treatment
• C. Have the client sign a consent for treatment
• D. Notify risk management before initiating treatment

Correct answer: A

Rationale: In emergency situations where a client is disoriented and has a cardiac arrhythmia, obtaining written consent may not be possible due to the urgency of the situation. The priority is to provide immediate treatment to ensure patient safety. Contacting the next of kin or having the client sign a consent form would cause unnecessary delays in providing critical care. Notifying risk management before initiating treatment is not the most appropriate action when dealing with a time-sensitive situation like a cardiac arrhythmia.

3. A nurse is preparing to discharge a client who has end-stage heart failure. The client's partner tells the nurse she can no longer handle caring for the client. Which of the following actions should the nurse take?

• A. Request another family member to assist the client's partner with care
• B. Recommend the partner to place the client in a long-term care facility
• C. Contact the case manager to discuss discharge options
• D. Ask the provider to delay the client's discharge home for a few more days

Correct answer: C

Rationale: The nurse should contact the case manager to discuss discharge options and support the client's partner. This action is appropriate as it involves seeking professional guidance and support for the client's partner who is struggling to care for the client. Option A is not the best choice as it solely focuses on involving another family member without addressing the partner's concerns directly. Option B is premature as recommending long-term care should be a well-considered decision involving multiple healthcare professionals. Option D delays the inevitable without providing a solution to the partner's current challenges.

4. What percentage of term newborns have a congenital heart disease due to environmental risk factors such as maternal alcoholism or drug ingestion?

• A. 2% to 4%
• B. 10% to 20%
• C. 5% to 10%
• D. 7% to 9%

Correct answer: A

Rationale: The correct answer is A: 2% to 4%. According to research, 2% to 4% of term newborns have congenital heart disease due to environmental risk factors such as maternal alcoholism or drug ingestion. Choices B, C, and D provide percentages that are higher than the actual prevalence of congenital heart disease in newborns caused by environmental factors, making them incorrect.

5. Which of the following strategies can help improve patient adherence to treatment plans?

• A. Providing clear and understandable instructions
• B. Using medical jargon
• C. Limiting patient education
• D. Ignoring patient feedback

Correct answer: A

Rationale: Providing clear and understandable instructions can help improve patient adherence to treatment plans. Clear instructions help patients better understand their treatment plans, leading to increased compliance. Choices B, C, and D are incorrect. Using medical jargon can confuse patients and reduce adherence. Limiting patient education deprives patients of essential information needed for adherence. Ignoring patient feedback can lead to misunderstandings and hinder the patient's commitment to the treatment plan.

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