Nursing Elites

1. A client with a history of hypertension is admitted with a blood pressure of 200/120 mm Hg. Which medication should the nurse prepare to administer?

• A. Metoprolol (Lopressor).
• B. Furosemide (Lasix).
• C. Lisinopril (Zestril).
• D. Nitroprusside (Nipride).

Correct answer: D

Rationale: The correct answer is D, Nitroprusside (Nipride). In this scenario of severe hypertension (200/120 mm Hg), a hypertensive emergency is present, requiring rapid reduction of blood pressure. Nitroprusside is a vasodilator that acts quickly to lower blood pressure in such emergencies. Options A, B, and C are incorrect: A) Metoprolol is a beta-blocker that lowers blood pressure but is not indicated for hypertensive emergencies requiring rapid reduction. B) Furosemide is a diuretic that helps with fluid retention but does not rapidly lower blood pressure. C) Lisinopril is an ACE inhibitor used for long-term management of hypertension, not for immediate reduction in hypertensive emergencies.

2. A client with a history of chronic kidney disease is receiving erythropoietin therapy. Which finding indicates that the therapy is effective?

• A. Hemoglobin of 12 g/dL.
• B. Reticulocyte count of 1%.
• C. Blood pressure of 130/80 mm Hg.
• D. Serum ferritin level of 100 ng/mL.

Correct answer: A

Rationale: The correct answer is A. A hemoglobin level of 12 g/dL is an indicator of effective erythropoietin therapy as it shows an increase in red blood cell production. Reticulocyte count (choice B) reflects the bone marrow's response to anemia but does not directly confirm the effectiveness of erythropoietin therapy. Blood pressure (choice C) and serum ferritin level (choice D) are not specific indicators of the effectiveness of erythropoietin therapy for chronic kidney disease.

3. During a home visit, the nurse observes that an elderly client has a cluttered living environment and poor lighting. What should the nurse do first?

• A. suggest that the client hires a cleaning service
• B. assist the client in organizing the living space
• C. assess the client's risk for falls
• D. provide the client with information on home safety

Correct answer: C

Rationale: The correct first action for the nurse to take is to assess the client's risk for falls. A cluttered living environment and poor lighting are significant risk factors for falls in the elderly. By assessing the client's risk for falls, the nurse can identify potential hazards and implement appropriate interventions to prevent falls. Suggesting hiring a cleaning service or assisting in organizing the living space may address the symptoms but not the root cause of the fall risk. Providing information on home safety is important but should come after assessing the specific risk factors for falls in this scenario.

4. The healthcare provider is assessing a client with a suspected pulmonary embolism. Which finding requires immediate intervention?

• A. Chest pain.
• B. Shortness of breath.
• C. Tachycardia.
• D. Cyanosis.

Correct answer: D

Rationale: Cyanosis is a late sign of hypoxemia and indicates severe oxygen deprivation, necessitating immediate intervention in a client with a suspected pulmonary embolism. Chest pain, shortness of breath, and tachycardia are also concerning symptoms in pulmonary embolism; however, cyanosis signifies critical oxygen deficiency and warrants urgent attention to prevent further complications.

5. The healthcare provider is preparing to administer an intravenous (IV) medication to a client. Which action should the healthcare provider take first?

• A. Verify the client's identity using two identifiers.
• B. Check the client's allergy status.
• C. Prepare the medication for administration.
• D. Administer the medication at the prescribed rate.

Correct answer: B

Rationale: Checking the client's allergy status is the priority before administering any medication, especially intravenously. This step helps identify any potential allergic reactions and prevents harm to the client. Verifying the client's identity using two identifiers is important but not the first step in medication administration. Preparing the medication for administration and administering the medication at the prescribed rate come after ensuring the client's safety by checking for allergies.

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