Nursing Elites

1. Before administering an antibiotic that can cause nephrotoxicity, which lab value is most important for the PN to review?

• A. Hemoglobin and Hematocrit
• B. Serum Calcium
• C. Serum Creatinine
• D. WBC

Correct answer: C

Rationale: Serum creatinine is the most important lab value to review before administering an antibiotic that can cause nephrotoxicity. This is because serum creatinine is a key indicator of kidney function. An elevated serum creatinine level may indicate impaired renal function, and administering nephrotoxic drugs in such situations can further damage the kidneys. Monitoring serum creatinine levels helps healthcare providers assess renal function and make informed decisions regarding drug administration. Choices A, B, and D are not as directly related to kidney function and nephrotoxicity, making them less crucial in this scenario. Hemoglobin and hematocrit levels assess for anemia, serum calcium levels are more related to bone health and nerve function, and WBC count is associated with immune response, none of which directly reflect kidney function or the risk of nephrotoxicity.

2. A dispersion consists of a solute dispersed through a dispersing vehicle. Which of the following dispersions is a liquid for topical application that contains insoluble solids or liquids?

• A. Ointment
• B. Lotion
• C. Paste
• D. Gel

Correct answer: B

Rationale: The correct answer is B, 'Lotion.' A lotion is a liquid dispersion that contains insoluble solids or liquids for topical application. Ointments are more semi-solid and occlusive, pastes are thicker and contain higher concentrations of solids, and gels have a jelly-like consistency due to their three-dimensional network structure. Therefore, among the options, a lotion is the most suitable choice for containing insoluble solids or liquids for topical application.

3. A client is admitted to the postoperative surgical unit with two test tubes after a left lobectomy. The nurse observed that the chambers are set at the prescribed suction of 20 cm water pressure, and tidying occurs with respirations and bubbling. What action should the nurse implement?

• A. Clamp the chest tube to see if the bubbling activity stops
• B. Notify the registered nurse of the observed bubbling
• C. Maintain system integrity to promote lung reexpansion
• D. Apply an occlusive dressing to the chest

Correct answer: C

Rationale: Maintaining system integrity is essential to promote lung reexpansion in postoperative patients with chest tubes. Clamping the chest tube abruptly can lead to tension pneumothorax, a life-threatening condition. The bubbling observed is a normal sign indicating that the system is functioning correctly, as it allows the drainage of air or fluid from the pleural space. Notifying the registered nurse may be necessary if there are significant concerns or changes observed, but the immediate action should be to ensure system integrity and lung reexpansion.

4. While performing an inspection of a client's fingernails, the PN observes a suspected abnormality of the nail's shape and character. Which finding should the PN document?

• A. Clubbed nails
• B. Splinter hemorrhages
• C. Longitudinal ridges
• D. Koilonychia or spoon nails

Correct answer: A

Rationale: The correct answer is A: Clubbed nails. Clubbed nails are a significant finding often associated with chronic hypoxia or lung disease. The presence of clubbed nails should be documented for further evaluation. Splinter hemorrhages (Choice B) are tiny areas of bleeding under the nails and are associated with conditions like endocarditis. Longitudinal ridges (Choice C) are common and often a normal finding in older adults. Koilonychia or spoon nails (Choice D) refer to nails that are concave or scooped out, often seen in conditions like iron deficiency anemia or hemochromatosis. These conditions are not typically associated with chronic hypoxia or lung disease, making them less likely findings in this situation.

5. What is the primary function of hemoglobin in red blood cells?

• A. Oxygen transport
• B. Immunity
• C. Blood clotting
• D. Carbon dioxide transport

Correct answer: A

Rationale: The correct answer is A: Oxygen transport. Hemoglobin in red blood cells binds to oxygen in the lungs and carries it to tissues throughout the body, releasing it where needed. This process is essential for cellular respiration and energy production. Choices B, C, and D are incorrect because hemoglobin's primary function is not related to immunity, blood clotting, or carbon dioxide transport. Hemoglobin's main role is to transport oxygen, ensuring adequate oxygen supply to body tissues for metabolic processes.

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