Nursing Elites

1. What should the nurse do before an echocardiogram for a client who has had a myocardial infarction?

• A. Ensuring no food or drink for 4 hours before the procedure
• B. Obtaining informed consent from the client
• C. Assessing for any history of iodine or shellfish allergies
• D. Informing the client about the painless nature and duration of the procedure

Correct answer: D

Rationale: The correct answer is to inform the client that the echocardiogram is a painless procedure that usually takes 30 to 60 minutes to complete. Echocardiography is a noninvasive, risk-free, and pain-free test that uses ultrasound to evaluate the heart's structure and motion. There is no need for special preparation before the procedure. Choices A, B, and C are incorrect because imposing nothing-by-mouth status, obtaining informed consent, and assessing for allergies to iodine or shellfish are not necessary steps before an echocardiogram.

2. A client recovering from surgery has a large abdominal wound. Which of the following foods, high in vitamin C, should the nurse encourage the client to eat to promote wound healing?

• A. Steak
• B. Veal
• C. Cheese
• D. Oranges

Correct answer: D

Rationale: Oranges are a rich source of vitamin C, which is essential for wound healing due to its role in collagen synthesis. Citrus fruits like oranges, as well as other fruits and vegetables such as strawberries, kiwi, bell peppers, and broccoli, are high in vitamin C. Meats like steak and veal are not significant sources of vitamin C; they are primarily sources of protein. Cheese is not a good source of vitamin C but does provide calcium and protein.

3. The patient is receiving a high dose of intravenous azithromycin to treat an infection and taking acetaminophen for pain. The nurse should expect to review which lab values when monitoring for this drug’s side effects?

• A. Complete blood counts
• B. Electrolytes
• C. Liver enzymes
• D. Urinalysis

Correct answer: C

Rationale: When a patient is receiving a high dose of intravenous azithromycin, which is a macrolide antibiotic, in combination with acetaminophen, a potentially hepatotoxic drug, the nurse should monitor liver enzymes. High doses of macrolides when taken with hepatotoxic drugs like acetaminophen can lead to hepatotoxicity. Reviewing liver enzymes helps in early detection of liver damage. Complete blood counts (Choice A) are not typically affected by azithromycin or acetaminophen. Electrolytes (Choice B) are not directly impacted by these medications. Urinalysis (Choice D) is not specifically indicated for monitoring the side effects of azithromycin and acetaminophen combination therapy.

4. A client admitted to the hospital with a diagnosis of acute pancreatitis has blood drawn for several serum laboratory tests. Which of the following serum amylase values, noted by the nurse reviewing the results, would be expected in this client at this time?

• A. 48 units/L
• B. 97 units/L
• C. 150 units/L
• D. 395 units/L

Correct answer: D

Rationale: The correct answer is D: "395 units/L." The normal serum amylase range is 25 to 151 units/L. In acute pancreatitis, the amylase level is greatly increased, typically exceeding the upper limit of the normal range. Choices A, B, and C fall within the normal range of serum amylase levels and would not be expected in a client with acute pancreatitis.

5. Which of the following is a common complication of immobility?

• A. Muscle hypertrophy.
• B. Pressure ulcers.
• C. Bone fractures.
• D. Joint stiffness.

Correct answer: B

Rationale: The correct answer is B, Pressure ulcers. Immobility can lead to pressure ulcers due to prolonged pressure on the skin, especially over bony prominences. Muscle hypertrophy (Choice A) is not a common complication of immobility; instead, muscle atrophy is more likely to occur due to disuse. Bone fractures (Choice C) can result from trauma but are not directly associated with immobility unless there is a fall or accident. Joint stiffness (Choice D) can develop due to lack of movement but is not as common or severe as pressure ulcers in cases of prolonged immobility.

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