Nursing Elites

1. All of the following are causes of vaginal bleeding in late pregnancy except:

• A. Placenta previa.
• B. Eclampsia.
• C. Abruptio placentae.
• D. Uterine rupture.

Correct answer: B

Rationale: The correct answer is B: Eclampsia. Eclampsia is a disorder of pregnancy characterized by hypertension, proteinuria, and edema. This condition can cause seizures and/or coma but does not typically present with vaginal bleeding. Choices A, C, and D are abnormal conditions that can cause bleeding, particularly in the third trimester. Placenta previa (choice A) is a condition where the placenta partially or completely covers the cervix, leading to vaginal bleeding. Abruptio placentae (choice C) is the premature separation of the placenta from the uterine wall, causing vaginal bleeding. Uterine rupture (choice D) is a serious obstetrical emergency where the uterus tears during pregnancy or childbirth, resulting in severe bleeding.

2. An LPN is talking with a client scheduled to undergo a vasectomy in the next few minutes. He states, "I know I signed the form and all, but I'm not feeling so sure of this. It can be reversed pretty easily, right?"? What is the LPN's best response?

• A. "Yes, vasectomies can be reversed, but once you have it, you may regret it later."?
• B. "It's normal to feel a little nervous before a procedure like this."?
• C. "It sounds like you have a few more questions you'd like answered. Let me grab the doctor quickly so he can answer them for you."?
• D. "It sounds like you might be a little nervous. Don't worry, this is a pretty minor procedure, and the doctor doing it is the best we have. You're in great hands."?

Correct answer: C

Rationale: The best response for the LPN is to acknowledge the client's concerns and offer to provide more information. By offering to get the doctor to answer any additional questions, the LPN shows respect for the client's right to informed consent. Option A provides some information but dismisses the client's uncertainty and implies they won't regret the decision, which may not be the case. Option B acknowledges nervousness but doesn't directly address the client's request for more information. Option D attempts to reassure the client but fails to address the need for additional questions to be answered by the doctor.

3. A client admitted to the hospital has a do-not-resuscitate (DNR) order in his medical record. The nurse understands which information about DNR orders?

• A. The only individuals who may change the DNR order are healthcare providers
• B. The DNR order can be changed if the client's condition warrants it
• C. The DNR order does not remain fixed for the duration of the client's hospitalization
• D. The DNR order requires frequent review as specified by state or agency policy

Correct answer: D

Rationale: The correct answer is that the DNR order requires frequent review as specified by state or agency policy. If the client's condition changes, the DNR order may need to be changed. For this reason, DNR orders require frequent review as specified by state or agency policy. A DNR order may be changed at any time and does not remain in effect for the duration of the client's hospitalization. The client's request regarding DNR status is the priority. Choice A is incorrect because healthcare providers, not just immediate family members, may change the DNR order based on the client's condition. Choice B is incorrect as DNR orders can be changed if the client's condition warrants it, not remaining unchanged. Choice C is incorrect as DNR orders are not fixed for the duration of hospitalization, they can be modified based on the client's needs.

4. Which of the following statements by a client indicates adequate understanding of preparation for a lipoprotein fractionation test?

• A. "I cannot eat or drink after midnight."?
• B. "I cannot eat for 12 hours before the test."?
• C. "I need to limit my fluid intake."?
• D. "I need to ingest a lipid solution."?

Correct answer: B

Rationale: The correct statement regarding preparation for a lipoprotein fractionation test is that the client cannot eat for 12 hours before the test. It is important to note that the client can drink an unrestricted amount of water. Limiting fluid intake is not necessary for this test. There is no need for the client to ingest a lipid solution as part of the preparation. Therefore, the other choices are incorrect.

5. Which of the following lab values is elevated first after a client has a myocardial infarction?

• A. LDH
• B. troponin
• C. CPK
• D. SGOT

Correct answer: B

Rationale: The correct answer is troponin. Troponin levels are the most specific and sensitive markers for myocardial infarction, and they begin to rise within a few hours after the event. CPK, SGOT, and LDH are also enzymes that can indicate myocardial damage, but troponin is the earliest and most specific indicator. CPK typically rises 4-8 hours after an infarction, followed by SGOT (AST) at 8-12 hours, and LDH at 12-24 hours post-infarction.

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