Nursing Elites

1. A nurse in the telemetry unit is receiving the laboratory findings for an adult male client who is being treated for a myocardial infarction. Which of the following is an expected finding for the client?

• A. Troponin I (TnI) 8 ng/mL
• B. Brain natriuretic peptide (BNP) 10 ng/L
• C. Alanine aminotransferase (ALT) 45 units/L
• D. High-density lipoprotein (HDL) 75 mg/dL

Correct answer: A

Rationale: The correct answer is A. Troponin I is a specific marker for myocardial infarction, and levels of 8 ng/mL are elevated, indicating heart muscle damage. Brain natriuretic peptide (BNP) is more related to heart failure rather than myocardial infarction, making choice B incorrect. Alanine aminotransferase (ALT) is a liver enzyme and not specific to myocardial infarction, so choice C is incorrect. High-density lipoprotein (HDL) is a type of cholesterol and is not typically used to diagnose or monitor myocardial infarction, making choice D incorrect.

2. A healthcare professional is preparing to administer 250 mg of an antibiotic IM. Available is 3 g/5 mL. How many mL would the healthcare professional administer per dose?

• A. 0.4 mL
• B. 0.3 mL
• C. 0.5 mL
• D. 0.6 mL

Correct answer: A

Rationale: To calculate the mL to be administered, convert 250 mg to grams (0.25 g). Then, set up a proportion: (0.25 g / 3 g) x 5 mL = 0.4167 mL, which rounds to 0.4 mL. Therefore, the healthcare professional would administer 0.4 mL per dose. Choice B (0.3 mL) is incorrect because it does not reflect the accurate calculation. Choice C (0.5 mL) is incorrect as it does not consider the correct conversion and calculation. Choice D (0.6 mL) is incorrect as it provides a value higher than the accurate calculation.

3. A nurse is caring for a postmenopausal client prescribed the aromatase inhibitor anastrozole for the treatment of breast cancer. Which of the following should the nurse inform the client she may experience?

• A. Weight gain
• B. Muscle and joint pain
• C. Night sweats
• D. Increased appetite

Correct answer: B

Rationale: The correct answer is B: Muscle and joint pain. Muscle and joint pain are common side effects of aromatase inhibitors like anastrozole. These side effects can be managed with analgesics as prescribed by the healthcare provider. Weight gain (choice A) is not typically associated with anastrozole. Night sweats (choice C) are also not commonly reported with this medication. Increased appetite (choice D) is not a common side effect of anastrozole.

4. A nurse is caring for a client with deep vein thrombosis (DVT). Which action should the nurse take?

• A. Position the client with the affected extremity lower than the heart
• B. Administer acetaminophen for pain
• C. Massage the affected extremity every 4 hours
• D. Withhold heparin IV infusion

Correct answer: D

Rationale: Withholding heparin IV infusion is the priority if there is a risk of complications such as bleeding, which must be evaluated before continuing treatment.

5. A client who was incarcerated for theft is addressing the group in a County Jail health clinic. Which of the following is an example of reaction formation?

• A. I steal things because it’s the only way I can keep my mind off my bad marriage
• B. I can’t believe I was accused of something I didn’t do
• C. I don’t want to talk about my feelings right now; we will talk more next time
• D. I think that people should earn money honestly, even though I stole

Correct answer: D

Rationale: The correct answer is D because reaction formation occurs when a person expresses the opposite of what they feel. In this case, the client is advocating for honesty, despite their own history of theft. Choice A discusses stealing to distract from a bad marriage, which does not involve expressing the opposite of one's feelings. Choice B focuses on denial, not reaction formation. Choice C involves delaying emotional discussion, which is not related to expressing the opposite of one's true feelings.

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