Nursing Elites

1. The nurse is preparing to administer a blood transfusion to a client. Which action is most important for the nurse to take before starting the transfusion?

• A. Administer pre-transfusion medication
• B. Ensure the client has an adequate fluid intake
• C. Monitor the client's vital signs
• D. Verify the blood type with another nurse

Correct answer: D

Rationale: Verifying the blood type with another nurse is critical before starting a blood transfusion to prevent a potentially life-threatening transfusion reaction. This step ensures that the client receives the correct blood product. Administering pre-transfusion medication, ensuring adequate fluid intake, and monitoring vital signs are important steps during the transfusion process, but verifying the blood type is the most crucial step to ensure patient safety.

2. The nurse is providing care for a client receiving total parenteral nutrition (TPN). Which action should the nurse include in the client's plan of care?

• A. Increase the TPN infusion rate if the client is hungry
• B. Administer TPN via a peripheral IV line
• C. Monitor blood glucose levels regularly
• D. Ensure the TPN solution is refrigerated at all times

Correct answer: C

Rationale: The correct action the nurse should include in the client's plan of care is to monitor blood glucose levels regularly. Clients receiving TPN are at risk for hyperglycemia due to the high glucose content of the solution. Regular monitoring of blood glucose levels is essential to ensure appropriate management of blood sugar. Choice A is incorrect because increasing the TPN infusion rate based on hunger is not a valid parameter for adjusting TPN. Choice B is incorrect because TPN should be administered through a central line, not a peripheral IV line, to prevent complications. Choice D is incorrect because TPN solutions should be stored at room temperature, not refrigerated.

3. A client with heart failure is prescribed digoxin. What assessment finding should the nurse report immediately?

• A. Bradycardia of 50 beats per minute.
• B. Heart rate of 110 beats per minute.
• C. Respiratory rate of 16 breaths per minute.
• D. Blood pressure of 130/80 mmHg.

Correct answer: A

Rationale: The correct answer is A: Bradycardia of 50 beats per minute. Bradycardia is a critical assessment finding in a client prescribed with digoxin, as it can indicate digoxin toxicity. Bradycardia is a known side effect of digoxin, and if left unaddressed, it can lead to serious complications such as arrhythmias or cardiac arrest. Both choices B, heart rate of 110 beats per minute, and C, respiratory rate of 16 breaths per minute, fall within normal ranges and do not raise immediate concerns. Choice D, blood pressure of 130/80 mmHg, is also within normal limits and does not indicate digoxin toxicity. Therefore, the nurse should report bradycardia promptly to prevent further complications.

4. A client with hypothyroidism is prescribed levothyroxine. What assessment finding suggests the medication is effective?

• A. Improved tolerance to cold.
• B. Decreased fatigue and improved energy levels.
• C. Reduced anxiety and improved mood.
• D. Increased sensitivity to heat.

Correct answer: B

Rationale: The correct answer is B: Decreased fatigue and improved energy levels. Levothyroxine is a medication used to treat hypothyroidism by providing the body with the thyroid hormone it lacks. Therefore, a positive response to the medication would manifest as decreased fatigue and improved energy levels due to the correction of the thyroid hormone imbalance. Choices A, C, and D are incorrect because improved tolerance to cold, reduced anxiety, and increased sensitivity to heat are not direct indicators of the effectiveness of levothyroxine in managing hypothyroidism.

5. A client with hyperparathyroidism is preparing for surgery. Which preoperative lab finding is most important to report?

• A. Elevated serum calcium.
• B. Decreased serum albumin.
• C. Elevated serum potassium.
• D. Elevated serum magnesium.

Correct answer: A

Rationale: The correct answer is A: Elevated serum calcium. In hyperparathyroidism, elevated calcium levels can lead to complications such as kidney stones, bone pain, and fractures. During surgery, high calcium levels can affect neuromuscular function, cardiac function, and blood clotting. Therefore, it is crucial to report elevated serum calcium levels preoperatively to prevent potential surgical complications. Choices B, C, and D are not directly associated with hyperparathyroidism and are less likely to impact the surgical outcome in this scenario.

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