Nursing Elites

1. An RN is making assignments for client care to an LPN at the beginning of the shift. Which of the following assignments should the LPN question?

• A. Assisting a client who is 24 hr postop to use an incentive spirometer
• B. Collecting a clean catch urine specimen from a client who was admitted on the previous shift
• C. Providing nasopharyngeal suctioning for a client who has pneumonia
• D. Replacing the cartridge and tubing on a PCA pump

Correct answer: D

Rationale: The LPN should question the assignment of replacing the PCA pump cartridge and tubing as it is outside the LPN's scope of practice. LPNs are not trained to handle tasks related to PCA pumps, which involve medication administration and monitoring that are typically within the RN's responsibilities. Assisting a postop client with an incentive spirometer (Choice A), collecting a clean catch urine specimen (Choice B), and providing nasopharyngeal suctioning for a client with pneumonia (Choice C) are all tasks that fall within the LPN's scope of practice and do not require questioning by the LPN.

2. What are the signs of an acute myocardial infarction?

• A. Chest pain radiating to the arm and shortness of breath
• B. Nausea, vomiting, and high fever
• C. Headache, confusion, and low blood pressure
• D. Increased heart rate and bradycardia

Correct answer: A

Rationale: The correct answer is A: Chest pain radiating to the arm and shortness of breath. These are classic signs of an acute myocardial infarction. Choice B is incorrect because nausea, vomiting, and high fever are not typical signs of a heart attack. Choice C is incorrect as headache, confusion, and low blood pressure are not specific to myocardial infarction. Choice D is incorrect because an acute myocardial infarction typically presents with an increased heart rate, not bradycardia.

3. How should a healthcare provider assess and manage a patient with anemia?

• A. Monitor hemoglobin levels and provide iron supplements
• B. Administer B12 injections
• C. Monitor for signs of infection and administer folic acid
• D. Administer oxygen therapy

Correct answer: A

Rationale: Corrected Question: To assess and manage a patient with anemia, monitoring hemoglobin levels and providing iron supplements are crucial. Anemia is commonly caused by iron deficiency, making iron supplementation a cornerstone of treatment. B12 injections (Choice B) are more relevant for treating megaloblastic anemia, not the typical iron-deficiency anemia. Monitoring for signs of infection and administering folic acid (Choice C) are important in specific types of anemia like megaloblastic anemia, but not the first-line approach for anemia management. Administering oxygen therapy (Choice D) is not the primary intervention for anemia unless severe hypoxemia is present, which is not typically seen in anemia.

4. A nurse is caring for a client who has been diagnosed with hyperkalemia. Which of the following findings should the nurse expect?

• A. Muscle weakness
• B. Nausea
• C. Increased thirst
• D. Restlessness

Correct answer: A

Rationale: Muscle weakness is a characteristic finding in hyperkalemia. High levels of potassium can affect the normal function of muscles, leading to weakness. Nausea and increased thirst are not typically associated with hyperkalemia. Restlessness is more commonly seen in conditions such as hypoxia or anxiety, not specifically in hyperkalemia.

5. A nurse is caring for a client who has multiple fractures following a motor-vehicle crash. For which of the following client statements should the nurse recommend a referral to an occupational therapist?

• A. I can't brush my teeth properly
• B. I am so frustrated I can't open my milk carton
• C. I can't hold a pencil
• D. I can't write anymore

Correct answer: B

Rationale: The correct answer is B. The client's frustration with opening a milk carton indicates difficulty with activities of daily living, which is a common concern addressed by occupational therapists. Choices A, C, and D are related to fine motor skills, which may also be addressed by an occupational therapist but are not as directly linked to activities of daily living as struggling with tasks like opening containers.

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