Nursing Elites

1. Which of the following white blood cell (WBC) counts clearly indicates leukocytosis?

• A. 4,500/mm³
• B. 7,000/mm³
• C. 10,000/mm³
• D. 25,000/mm³

Correct answer: D

Rationale: Leukocytosis is defined as an increase in the total white blood cell count. A normal WBC count typically ranges from 4,500 to 10,000/mm³. A WBC count of 25,000/mm³, as indicated in choice D, is significantly higher than the normal range and clearly indicates leukocytosis.

2. Which of the following scenarios represents nursing malpractice?

• A. The nurse administers penicillin to a patient with a documented history of allergy to the drug. The patient experiences an allergic reaction and suffers cerebral damage due to anoxia.
• B. The nurse applies a hot water bottle or a heating pad to the abdomen of a patient with abdominal cramping.
• C. The nurse assists a patient out of bed with the bed locked in position; the patient slips and fractures his right humerus.
• D. The nurse administers the wrong medication to a patient, resulting in vomiting. This error is documented and reported to the physician and the nursing supervisor.

Correct answer: A

Rationale: The correct answer is A. Administering a drug to a patient with a known allergy, leading to severe harm such as an allergic reaction causing cerebral damage due to anoxia, constitutes nursing malpractice. In this scenario, the nurse failed to adhere to the standard of care by administering a medication that the patient was allergic to, resulting in serious harm, which is a clear example of malpractice in nursing.

3. A patient with no known allergies is to receive penicillin every 6 hours. When administering the medication, the nurse observes a fine rash on the patient’s skin. The most appropriate nursing action would be to:

• A. Withhold the medication and notify the physician
• B. Administer the medication and notify the physician
• C. Administer the medication with an antihistamine
• D. Apply corn starch soaks to the rash

Correct answer: A

Rationale: In this scenario, the appearance of a rash after administering penicillin, even in a patient with no known allergies, is concerning for a potential allergic reaction. The appropriate action for the nurse to take is to withhold the medication and notify the physician. This precaution is necessary to prevent further administration of a medication that may be causing an adverse reaction, as allergic reactions can range from mild to severe and require immediate intervention.

4. When teaching about electrical fire prevention at a community health fair, which of the following information should be included?

• A. Use three-pronged grounded plugs.
• B. Cover extension cords with a rug.
• C. Check for tingling sensations around the cord to ensure electricity is working.
• D. Remove the plug from the socket by pulling the plug, not the cord.

Correct answer: A

Rationale: The correct answer is to use three-pronged grounded plugs because they are safer and reduce the risk of electrical fires. Option B is incorrect as covering extension cords with a rug can pose a fire hazard. Option C is incorrect; tingling sensations around a cord indicate an electrical issue, not proper functioning. Option D is unsafe; plugs should be removed from the socket by pulling the plug, not the cord, to prevent damage and reduce the risk of electrical hazards.

5. A healthcare provider is reviewing the laboratory report of a client who has been taking lithium carbonate for the past 12 months. The provider notes a lithium level of 0.8 mEq/L. Which of the following orders from the provider should the healthcare provider expect?

• A. Withhold the next dose
• B. Increase the dosage
• C. Discontinue the medication
• D. Administer the medication

Correct answer: D

Rationale: A lithium level of 0.8 mEq/L falls within the therapeutic range for maintaining the drug's effectiveness while minimizing toxicity. Therefore, the appropriate action would be to continue administering the medication as prescribed by the healthcare provider to maintain the therapeutic effect for the client.

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