Nursing Elites

1. The nurse is analyzing laboratory values for the assigned clients. Which finding, based on the client's medical history, indicates the need for immediate follow-up?

• A. Client with chronic kidney disease and serum creatinine of 1.6 mg/dL
• B. Client with diabetes mellitus and a glycosylated hemoglobin A (HbA1c) of 7.0%
• C. Client with heart failure and a B-type natriuretic peptide (BNP) of 140 pg/mL
• D. Client who is male and has anemia with hemoglobin of 16.5 g/dL and hematocrit of 45%

Correct answer: B

Rationale: An HbA1c of 7.0% in a client with diabetes mellitus indicates poor long-term glucose control, necessitating immediate follow-up. Elevated HbA1c levels suggest a higher average blood sugar over the past 2-3 months, increasing the risk of complications associated with diabetes. Choices A, C, and D do not require immediate follow-up based solely on the provided information. A serum creatinine of 1.6 mg/dL in a client with chronic kidney disease, a BNP of 140 pg/mL in a client with heart failure, and hemoglobin of 16.5 g/dL and hematocrit of 45% in a male client with anemia are within acceptable ranges or do not indicate an urgent need for intervention.

2. Which of the following statements about medications is true?

• A. Over-the-counter medications are unlikely to interact with food or nutrients
• B. Prescription medications always have significant interactions with food
• C. Prescription and nonprescription drugs and herbal remedies interact with food
• D. Herbal products are generally safe since they are natural

Correct answer: C

Rationale: The correct answer is C. This statement is true because both prescription medications and over-the-counter medications, along with herbal remedies, can interact with food. Choice A is incorrect because over-the-counter medications can also interact with food or nutrients. Choice B is incorrect as not all prescription medications have significant interactions with food. Choice D is misleading because herbal products are not always safe, as they can have side effects and interact with other medications.

3. What is the most crucial and most difficult management skill required of the M6 practical nurse?

• A. Preparing time schedules and task assignment rosters
• B. Inspecting equipment for damage and proper function
• C. Preparing reports and maintaining records
• D. Effectively managing personnel

Correct answer: D

Rationale: Correct. Effectively managing personnel is indeed the most crucial and difficult management skill required of a practical nurse. This skill involves supervising, motivating, and coordinating the work of other healthcare staff, ensuring optimal patient care. Choices A, B, and C are important tasks but do not necessarily involve the same level of complexity and interpersonal skills required for managing personnel in a healthcare setting.

4. Which medication should a patient with a history of peptic ulcer disease avoid?

• A. Acetaminophen
• B. Antacids
• C. Nonsteroidal anti-inflammatory drugs
• D. Antihistamines

Correct answer: C

Rationale: Patients with a history of peptic ulcer disease should avoid Nonsteroidal anti-inflammatory drugs (NSAIDs) because they can worsen peptic ulcers due to their effects on the stomach lining. Acetaminophen (Choice A) is a safer alternative for pain relief in such patients as it does not have the same ulcerogenic effects. Antacids (Choice B) can actually help alleviate symptoms by neutralizing stomach acid and are generally safe to use. Antihistamines (Choice D) are not known to exacerbate peptic ulcers and can be used safely for conditions like allergies.

5. A client has been given instructions about ferrous sulfate. Which statement made by the client would indicate the client needs further education?

• A. "I will take this medication with a full glass of milk."
• B. "I will take the morning dose 1 hour before breakfast."
• C. "I will need to avoid taking this medication with coffee."
• D. "I will take antacids if needed, 2 hours after I take ferrous sulfate."

Correct answer: A

Rationale: The correct answer is A. Ferrous sulfate should not be taken with milk as it can impair iron absorption. Choice B is correct as taking the morning dose 1 hour before breakfast is appropriate. Choice C is correct as coffee can interfere with iron absorption. Choice D is correct as antacids should be taken 2 hours after ferrous sulfate to avoid interference with its absorption.

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