Nursing Elites

1. A client with 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: Hemoglobin of 12 g/dL. Erythropoietin therapy stimulates red blood cell production, leading to an increase in hemoglobin levels. A hemoglobin level of 12 g/dL indicates that the therapy is effective in managing anemia associated with chronic kidney disease. Choice B, a reticulocyte count of 1%, is not a direct indicator of the effectiveness of erythropoietin therapy. Choice C, a blood pressure of 130/80 mm Hg, is important to monitor in clients with chronic kidney disease but does not specifically indicate the effectiveness of erythropoietin therapy. Choice D, a serum ferritin level of 100 ng/mL, is related to iron stores in the body and may be monitored during erythropoietin therapy but does not directly reflect the therapy's effectiveness in increasing red blood cell production.

2. When planning a scoliosis screening clinic, which age group should be included?

• A. early adolescent girls
• B. late adolescent boys
• C. 7-10 year old boys
• D. preschoolers of both genders

Correct answer: A

Rationale: The correct answer is early adolescent girls. Scoliosis is most commonly diagnosed during early adolescence, with girls being more affected than boys. Including early adolescent girls in the screening clinic aligns with the age group that is at higher risk for scoliosis. Late adolescent boys (choice B) are less likely to develop scoliosis compared to early adolescent girls. 7-10 year old boys (choice C) are typically younger than the age group where scoliosis is commonly diagnosed. Preschoolers of both genders (choice D) are too young for scoliosis screening as the condition usually manifests during adolescence.

3. The instructor is teaching a prenatal class about the importance of folic acid. Which outcome indicates that the teaching was effective?

• A. participants can list foods high in folic acid
• B. participants plan to take folic acid supplements daily
• C. participants understand the risks of folic acid deficiency
• D. participants demonstrate how to read nutrition labels for folic acid content

Correct answer: B

Rationale: The correct answer is B because planning to take folic acid supplements daily is a proactive step towards preventing folic acid deficiency and reducing the risk of neural tube defects in pregnancy. While choice A is important for dietary knowledge, the direct action of taking supplements is more effective. Choice C, understanding the risks, is good but does not ensure action. Choice D, reading nutrition labels, is helpful but doesn't guarantee intake of folic acid.

4. The nurse is caring for a client with liver cirrhosis. Which assessment finding requires immediate intervention?

• A. Jaundice.
• B. Ascites.
• C. Peripheral edema.
• D. Spider angiomas.

Correct answer: D

Rationale: Spider angiomas are abnormal clusters of blood vessels near the skin surface and can be indicative of an underlying liver condition. In the context of liver cirrhosis, spider angiomas can suggest portal hypertension and liver dysfunction, which requires immediate intervention. Jaundice (choice A) is a common manifestation of liver cirrhosis but not typically an immediate intervention priority unless severe. Ascites (choice B) and peripheral edema (choice C) are also common in liver cirrhosis but do not require immediate intervention unless they are causing respiratory compromise or other urgent issues.

5. A client with a history of asthma is admitted with shortness of breath. Which finding requires immediate intervention?

• A. Increased respiratory rate.
• B. Absence of breath sounds.
• C. Expiratory wheezes.
• D. Productive cough with green sputum.

Correct answer: B

Rationale: The correct answer is B: Absence of breath sounds. This finding can indicate a pneumothorax or severe asthma exacerbation, both of which require immediate intervention to ensure adequate ventilation and prevent further complications. Increased respiratory rate (choice A) is common in asthma exacerbations but may not always necessitate immediate intervention. Expiratory wheezes (choice C) are typical in asthma and may not always indicate a critical condition. A productive cough with green sputum (choice D) suggests a possible respiratory infection but does not warrant immediate intervention as much as the absence of breath sounds.

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