Nursing Elites

1. A male client reports numbness and tingling in his fingers and around his mouth. What laboratory value should the nurse review?

• A. Capillary glucose.
• B. Serum calcium.
• C. Urine specific gravity.
• D. White blood cell count.

Correct answer: B

Rationale: The correct answer is B, Serum calcium. Numbness and tingling in the fingers and around the mouth are indicative of hypocalcemia, a condition characterized by low calcium levels in the blood. Reviewing the client's serum calcium levels is crucial in this situation to assess for hypocalcemia. Choice A, Capillary glucose, is incorrect because symptoms described are not typically associated with glucose abnormalities. Choice C, Urine specific gravity, and Choice D, White blood cell count, are unrelated to the symptoms presented and are not indicative of the client's condition.

2. While palpating the gallbladder of a mildly obese client, what finding does the nurse expect if the gallbladder is inflamed?

• A. Severe tenderness and guarding
• B. Slight discomfort upon palpation
• C. A sensation of fullness
• D. No symptoms unless the gallbladder is extremely inflamed

Correct answer: A

Rationale: Correct. If the gallbladder is inflamed, the nurse would expect to find severe tenderness and guarding, which are typical signs of acute cholecystitis. This indicates an inflammatory process in the gallbladder. Choices B, C, and D are incorrect because slight discomfort, a sensation of fullness, or no symptoms unless extremely inflamed are not typical findings associated with gallbladder inflammation.

3. A client scheduled for a bronchoscopy in the morning is anxious and asking the nurse numerous questions about the procedure. Which intervention has the highest priority in preparing the client for the procedure?

• A. Provide detailed education about the procedure
• B. Administer prescribed anti-anxiety medication
• C. Instruct client to write down the questions
• D. Reassure the client about the safety of the procedure

Correct answer: C

Rationale: Encouraging the client to write down questions is the highest priority as it allows the nurse to address concerns systematically, reducing anxiety. This approach empowers the client and ensures that all concerns are covered before the procedure, reducing the risk of miscommunication or unaddressed fears. Providing detailed education about the procedure (choice A) is important but may not address the client's immediate anxiety. Administering anti-anxiety medication (choice B) should only be done if other interventions are ineffective or if prescribed by the healthcare provider. Reassuring the client about the safety of the procedure (choice D) is essential but may not address the specific questions and concerns causing anxiety.

4. A client with multiple sclerosis is experiencing fatigue. What is the nurse's priority intervention?

• A. Encourage the client to increase physical activity.
• B. Encourage the client to take rest breaks during activities.
• C. Administer a stimulant medication to reduce fatigue.
• D. Advise the client to use energy conservation techniques.

Correct answer: D

Rationale: The correct answer is D: Advise the client to use energy conservation techniques. Energy conservation techniques are crucial in managing fatigue in multiple sclerosis. These techniques involve prioritizing activities, pacing oneself, and taking rest breaks to prevent overexertion, which can exacerbate fatigue. Encouraging the client to increase physical activity (choice A) may worsen fatigue if not done with proper energy conservation. Taking rest breaks during activities (choice B) is important but falls secondary to teaching energy conservation techniques. Administering a stimulant medication to reduce fatigue (choice C) should not be the priority as non-pharmacological interventions like energy conservation should be attempted first.

5. A client with type 1 diabetes mellitus is admitted to the emergency department with confusion, sweating, and a blood sugar level of 45 mg/dL. What is the nurse's priority action?

• A. Administer 50% dextrose IV push
• B. Provide a carbohydrate snack
• C. Check the client's urine for ketones
• D. Start an insulin drip

Correct answer: A

Rationale: A blood sugar level of 45 mg/dL indicates severe hypoglycemia, which can lead to life-threatening complications if not treated immediately. The priority is to administer IV dextrose to rapidly increase the blood sugar level. Administering 50% dextrose IV push will provide a quick source of glucose to raise the blood sugar. Providing a carbohydrate snack is not the immediate priority in this critical situation. Checking the client's urine for ketones is important in diabetic ketoacidosis, not for hypoglycemia. Starting an insulin drip would further lower the blood sugar and worsen the client's condition.

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