Nursing Elites

1. What is the priority intervention for a patient with suspected pulmonary embolism?

• A. Administer oxygen
• B. Administer anticoagulants
• C. Administer bronchodilators
• D. Reposition the patient

Correct answer: A

Rationale: Administering oxygen is the priority intervention for a patient with suspected pulmonary embolism. Maintaining adequate oxygenation is crucial in these patients to prevent hypoxemia and support oxygen delivery to tissues. Administering anticoagulants may be necessary but is not the initial priority. Administering bronchodilators is not indicated for pulmonary embolism. Repositioning the patient does not address the immediate need for oxygenation.

2. A nurse is caring for a client with schizophrenia. Which of the following assessment findings should the nurse expect?

• A. Decreased level of consciousness
• B. Inability to identify common objects
• C. Poor problem-solving ability
• D. Preoccupation with somatic disturbances

Correct answer: B

Rationale: In schizophrenia, clients often display an inability to identify common objects due to cognitive impairment. This is known as associative agnosia, where individuals struggle to recognize familiar objects, faces, or sounds. Choices A, C, and D are not typically associated with schizophrenia. Decreased level of consciousness is more indicative of conditions like head trauma or drug overdose. Poor problem-solving ability may be seen in various mental health disorders but is not specific to schizophrenia. Preoccupation with somatic disturbances is more commonly seen in somatic symptom disorders or somatic delusions, not a typical finding in schizophrenia.

3. A healthcare professional is reviewing the laboratory results of a client who has rheumatoid arthritis. Which of the following findings should be reported to the provider?

• A. WBC count 8,000/mm3
• B. Platelets 150,000/mm3
• C. Aspartate aminotransferase 10 units/L
• D. Erythrocyte sedimentation rate 75 mm/hr

Correct answer: D

Rationale: The correct answer is D. A high erythrocyte sedimentation rate (ESR) of 75 mm/hr indicates inflammation, which is common in rheumatoid arthritis. Elevated ESR levels are often seen in inflammatory conditions like rheumatoid arthritis. Options A, B, and C are within the normal range and are not typically indicative of active inflammation associated with rheumatoid arthritis. Therefore, the nurse should report the elevated ESR level to the provider for further evaluation and management.

4. A nurse is providing teaching to a client who has a new prescription for warfarin. Which of the following statements indicates a need for further teaching?

• A. I will take warfarin every other day.
• B. I will eat more leafy green vegetables while taking warfarin.
• C. I will use a soft toothbrush while taking warfarin.
• D. I will have my INR checked regularly while taking warfarin.

Correct answer: B

Rationale: The correct answer is B. Eating more leafy green vegetables can increase vitamin K intake, which may reduce the effectiveness of warfarin. This can lead to fluctuations in the International Normalized Ratio (INR) levels, affecting the medication's efficacy. Choices A, C, and D are correct statements. Taking warfarin every other day, using a soft toothbrush to prevent gum bleeding, and having regular INR checks are all appropriate and important actions when taking warfarin.

5. A nurse is assessing a client who is receiving a blood transfusion. Which of the following findings should the nurse identify as an indication of a hemolytic transfusion reaction?

• A. Low back pain.
• B. Bradycardia.
• C. Chills.
• D. Distended neck veins.

Correct answer: A

Rationale: The correct answer is A: Low back pain. Low back pain is a common sign of a hemolytic transfusion reaction, indicating the destruction of red blood cells. This finding requires immediate intervention as it can lead to serious complications such as renal failure. Bradycardia (choice B) is not typically associated with a hemolytic transfusion reaction. Chills (choice C) can be seen in febrile non-hemolytic transfusion reactions. Distended neck veins (choice D) are more indicative of fluid overload rather than a hemolytic reaction.

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