Nursing Elites

1. What is the initial action for a healthcare provider when a patient presents with shortness of breath?

• A. Administer oxygen
• B. Reposition the patient
• C. Check for abnormal breath sounds
• D. Check oxygen saturation

Correct answer: A

Rationale: Administering oxygen is the initial action for a healthcare provider when a patient presents with shortness of breath because it helps alleviate the patient's symptoms by improving oxygenation. Providing oxygen takes precedence over other actions such as repositioning the patient, checking for abnormal breath sounds, or assessing oxygen saturation. While these actions are important, ensuring the patient has an adequate oxygen supply is crucial in the initial management of shortness of breath.

2. A healthcare provider is providing discharge instructions to a client who has a new prescription for metformin. Which of the following instructions should the healthcare provider include?

• A. Take this medication with meals.
• B. Avoid consuming alcohol while taking this medication.
• C. Take this medication at bedtime.
• D. Report any muscle pain to your healthcare provider.

Correct answer: B

Rationale: The correct answer is B: 'Avoid consuming alcohol while taking this medication.' Clients taking metformin should avoid alcohol as it increases the risk of lactic acidosis. Choice A is incorrect because metformin is usually taken with meals to reduce gastrointestinal side effects. Choice C is incorrect as metformin is typically taken with meals, not at bedtime. Choice D is incorrect because muscle pain is not a common side effect of metformin.

3. A nurse is assessing a client who is postoperative following a total knee arthroplasty. Which of the following findings should the nurse report to the provider?

• A. Heart rate of 90/min
• B. Capillary refill of 2 seconds
• C. Wound drainage of 30 mL in 8 hours
• D. Warmth and redness in the calf

Correct answer: D

Rationale: The correct answer is D. Warmth and redness in the calf are indicative of a possible deep vein thrombosis (DVT), a serious complication post-surgery that requires immediate attention. Reporting this finding promptly to the provider is crucial for timely intervention. Choices A, B, and C are within normal limits for a postoperative client and do not indicate a potentially life-threatening condition like DVT.

4. A client who is at 12 weeks of gestation and has hyperemesis gravidarum is being cared for by a nurse. Which of the following laboratory values should the nurse report to the provider?

• A. Sodium 140 mEq/L
• B. Potassium 3.8 mEq/L
• C. Blood glucose 90 mg/dL
• D. Urine ketones present

Correct answer: D

Rationale: The correct answer is D: Urine ketones present. The presence of urine ketones indicates dehydration and inadequate glucose control in clients with hyperemesis gravidarum. Reporting this finding to the provider is crucial for prompt intervention to prevent further complications. Choices A, B, and C are within normal ranges and do not directly correlate with the condition of hyperemesis gravidarum. Therefore, they are not the priority values to report in this scenario.

5. A nurse is assessing a client in active labor. The FHR baseline has been 100/min for 15 minutes. What condition should the nurse suspect?

• A. Maternal fever.
• B. Fetal anemia.
• C. Maternal hypoglycemia.
• D. Chorioamnionitis.

Correct answer: C

Rationale: In this scenario, with a fetal heart rate (FHR) baseline of 100/min for 15 minutes, the nurse should suspect maternal hypoglycemia. Maternal hypoglycemia can result in fetal bradycardia, which is defined as an FHR less than 110 beats per minute. Maternal hypoglycemia requires prompt intervention to prevent adverse outcomes for both the mother and the fetus. Maternal fever (Choice A) typically presents with tachycardia rather than bradycardia in the fetus. Fetal anemia (Choice B) is more likely to present with other signs such as pallor or tachycardia rather than bradycardia. Chorioamnionitis (Choice D) is characterized by maternal fever, uterine tenderness, and foul-smelling amniotic fluid, but it is not directly linked to the FHR baseline being 100/min.

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