Nursing Elites

1. A 65-year-old client is taking methylprednisolone. What pharmacological action should the nurse expect with this therapy?

• A. Suppression of beta2 receptors.
• B. Suppression of airway mucus production.
• C. Fortification of bones.
• D. Suppression of candidiasis.

Correct answer: B

Rationale: The correct answer is B: 'Suppression of airway mucus production.' Methylprednisolone, a corticosteroid, is known to suppress airway mucus production. While corticosteroids can enhance the responsiveness of beta2 receptors, they are not directly involved in the suppression of these receptors (Choice A). Corticosteroids can lead to adverse effects such as bone loss, rather than fortification of bones (Choice C). They can also increase the risk of infections like candidiasis but do not directly suppress it (Choice D). Therefore, the most expected pharmacological action of methylprednisolone therapy is the suppression of airway mucus production.

2. A healthcare professional is assessing a client for signs of fluid overload. Which of the following findings should the healthcare professional look for?

• A. Weight loss
• B. Decreased blood pressure
• C. Edema
• D. Increased urine output

Correct answer: C

Rationale: Edema is a common sign of fluid overload. When the body retains more fluid than it excretes, it can lead to edema, which is swelling caused by excess fluid trapped in body tissues. Weight gain, not weight loss, is typically associated with fluid overload due to the retained fluids. Decreased blood pressure is more commonly associated with dehydration rather than fluid overload. Increased urine output is a sign of the body trying to eliminate excess fluids, which is contrary to the signs of fluid overload.

3. A healthcare professional is reviewing the lab report of a client who has been experiencing a fever for the last 3 days. What lab result indicates the client is experiencing fluid volume deficit (FVD)?

• A. Decreased hematocrit
• B. Increased BUN
• C. Increased hematocrit
• D. Decreased urine specific gravity

Correct answer: C

Rationale: An increased hematocrit level indicates dehydration or fluid volume deficit. Hematocrit measures the proportion of blood volume that is occupied by red blood cells, and when a client is experiencing fluid volume deficit, there is less fluid in the blood, causing the concentration of red blood cells to be higher, leading to an increased hematocrit level. Decreased hematocrit (Choice A) is more indicative of fluid volume excess. Increased BUN (Choice B) is associated with renal function and dehydration but is not a direct indicator of FVD. Decreased urine specific gravity (Choice D) is also associated with dehydration, but an increased hematocrit is a more specific indicator of fluid volume deficit.

4. A nurse is planning a staff education program to review nursing interventions for patients who have kidney failure. What source should the nurse identify as the best source for obtaining evidence-based practice information?

• A. A recent peer-reviewed nursing research article
• B. A website for a nursing association
• C. A textbook published 5 years ago
• D. An expert opinion from a seasoned nurse

Correct answer: A

Rationale: The correct answer is A: A recent peer-reviewed nursing research article. Peer-reviewed research articles provide the most current and reliable evidence-based practice information for clinical care. Choice B, a website for a nursing association, may have valuable information but may not always guarantee the highest level of evidence. Choice C, a textbook published 5 years ago, may not reflect the most up-to-date practices and guidelines. Choice D, an expert opinion from a seasoned nurse, though valuable, is not as reliable as evidence derived from peer-reviewed research articles.

5. A nurse is caring for a client receiving heparin. Which of the following should the nurse monitor?

• A. INR levels
• B. APTT levels
• C. Blood glucose levels
• D. Liver function tests

Correct answer: B

Rationale: Heparin therapy requires monitoring of activated partial thromboplastin time (APTT) to ensure therapeutic levels. APTT reflects the intrinsic pathway of the clotting cascade and is used to assess the effectiveness and safety of heparin therapy. Monitoring INR levels is more relevant for assessing warfarin therapy, not heparin. Blood glucose levels are monitored for clients with diabetes or those on medications affecting glucose levels. Liver function tests are used to assess liver health and are not directly related to monitoring heparin therapy.

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