Nursing Elites

1. Which lab test is used to assess renal function?

• A. Check blood glucose levels
• B. Monitor serum creatinine
• C. Monitor BUN
• D. Check electrolyte levels

Correct answer: B

Rationale: The correct answer is B: Monitor serum creatinine. Serum creatinine is a key indicator of renal function as it reflects the glomerular filtration rate. An increase in serum creatinine levels indicates impaired kidney function. Checking blood glucose levels (choice A) is not specific to assessing renal function but is used to diagnose diabetes. Monitoring BUN (choice C) is important but not as specific as serum creatinine in assessing renal function. Checking electrolyte levels (choice D) is essential in assessing kidney function but is not as specific as monitoring serum creatinine.

2. A client is 2 hr postoperative following a total hip arthroplasty. Which of the following actions should the nurse take?

• A. Position the client supine with a pillow between the legs.
• B. Place an abduction pillow between the client's legs.
• C. Place a pillow under the client's knees.
• D. Position the client's legs in adduction.

Correct answer: B

Rationale: After a total hip arthroplasty, it is crucial to prevent hip dislocation. Placing an abduction pillow between the client's legs helps maintain proper alignment of the hip joint and prevents adduction, which could lead to dislocation. Therefore, choice B is the correct action. Choice A is incorrect because positioning the client supine with a pillow between the legs does not provide the necessary abduction to prevent dislocation. Choice C, placing a pillow under the client's knees, does not address the need for abduction. Choice D, positioning the client's legs in adduction, is incorrect as adduction increases the risk of hip dislocation following hip arthroplasty.

3. Which of the following is a sign of digoxin toxicity?

• A. Bradycardia
• B. Hypertension
• C. Tachycardia
• D. Tachypnea

Correct answer: A

Rationale: The correct answer is A, Bradycardia. Bradycardia, or a slower than normal heart rate, is a classic sign of digoxin toxicity. Digoxin is a medication commonly used to treat heart conditions, but an excess of digoxin in the body can lead to toxicity. This toxicity can manifest as various symptoms, with bradycardia being one of the most common ones. Hypertension (high blood pressure) and tachycardia (fast heart rate) are not typical signs of digoxin toxicity. Tachypnea, which refers to rapid breathing, is also not a common sign of digoxin toxicity.

4. A nurse is preparing to administer a unit of packed RBCs to a client. Which of the following actions should the nurse take?

• A. Prime the IV tubing with 0.9% sodium chloride.
• B. Verify the client's blood type and Rh factor.
• C. Administer the blood over 8 hours.
• D. Use a 22-gauge needle for venous access.

Correct answer: B

Rationale: The correct answer is to verify the client's blood type and Rh factor. This action is crucial to ensure that the correct blood is administered, matching the client's blood type and Rh factor, which helps prevent transfusion reactions. Priming the IV tubing with 0.9% sodium chloride (Choice A) is not directly related to ensuring the correct blood product is administered. Administering the blood over 8 hours (Choice C) is not the standard practice for packed RBCs, which are usually given over a shorter period. Using a 22-gauge needle for venous access (Choice D) is not specific to the preparation for administering packed RBCs.

5. A nurse overhears two assistive personnel (AP) discussing care for a client in the elevator. What action should the nurse take?

• A. Contact the client's family about the incident.
• B. Notify the client's provider about the incident.
• C. File a complaint with the ethics committee.
• D. Report the incident to the AP's charge nurse.

Correct answer: D

Rationale: The correct action for the nurse to take in this situation is to report the incident to the AP's charge nurse. This ensures that the issue is addressed internally and allows for proper handling of the situation. Contacting the client's family about the incident (Choice A) may not be appropriate as it could breach confidentiality and escalate the situation unnecessarily. Notifying the client's provider (Choice B) is not the most immediate and effective step to address the issue. Filing a complaint with the ethics committee (Choice C) should be reserved for serious ethical violations, and in this case, reporting to the charge nurse is the more practical and immediate course of action.

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