Nursing Elites

1. A nurse is assessing a client who has a history of gastroesophageal reflux disease (GERD). Which of the following findings should the nurse identify as a complication of GERD?

• A. Hematemesis.
• B. Melena.
• C. Pallor.
• D. Steatorrhea.

Correct answer: A

Rationale: The correct answer is A: Hematemesis. Hematemesis (vomiting blood) is a sign of gastrointestinal bleeding and a serious complication of GERD. Melena (black, tarry stool) is also a sign of GI bleeding but is not as specific to GERD as hematemesis. Pallor may be present due to anemia from chronic blood loss, but it is not a direct complication of GERD. Steatorrhea is not typically associated with GERD; it is more indicative of malabsorption issues.

2. A healthcare professional is preparing to administer an IV bolus of morphine to a client. Which of the following actions should the healthcare professional take first?

• A. Check the client's respiratory rate.
• B. Administer naloxone.
• C. Check the client's pain level.
• D. Assess the client's blood pressure.

Correct answer: A

Rationale: Correct Answer: Checking the client's respiratory rate is the priority before administering morphine because morphine can depress respiration. This action helps the healthcare professional assess the client's baseline respiratory status and detect any potential respiratory depression that may be exacerbated by morphine. Choice B, administering naloxone, is incorrect because naloxone is used as an antidote for opioid overdose and not routinely administered before giving morphine. Choice C, checking the client's pain level, is important but not the first action to take before administering morphine. Choice D, assessing the client's blood pressure, is also important but not the initial priority compared to evaluating respiratory status when preparing to administer morphine.

3. A nurse is reviewing laboratory data for a client who has chronic kidney disease. Which of the following findings should the nurse expect?

• A. Increased creatinine
• B. Increased hemoglobin
• C. Increased bicarbonate
• D. Increased calcium

Correct answer: A

Rationale: The correct answer is A: Increased creatinine. In chronic kidney disease, the kidneys are unable to filter waste effectively, leading to a buildup of creatinine in the blood. This results in increased creatinine levels in laboratory tests. Choice B, increased hemoglobin, is not typically associated with chronic kidney disease. Choice C, increased bicarbonate, is also not a common finding in chronic kidney disease; in fact, metabolic acidosis with decreased bicarbonate levels is more common. Choice D, increased calcium, is not expected in chronic kidney disease; instead, calcium levels may be low due to impaired kidney function.

4. Which of the following actions is appropriate when administering a blood transfusion?

• A. Verify patient identity
• B. Administer medication
• C. Monitor vital signs
• D. Start blood transfusion without verification

Correct answer: A

Rationale: Verifying the patient's identity is a critical step when administering a blood transfusion to ensure that the correct blood product is given to the right patient. This process helps prevent errors and enhances patient safety. Choice B, 'Administer medication,' is incorrect because the focus during a blood transfusion should be on ensuring the correct blood product is administered. Choice C, 'Monitor vital signs,' is also important but comes after verifying the patient's identity. Choice D, 'Start blood transfusion without verification,' is incorrect and unsafe as patient identification verification is essential prior to starting any medical procedure, especially one as important as a blood transfusion.

5. Which assessment finding is most concerning in a patient receiving morphine?

• A. Hypotension
• B. Bradycardia
• C. Respiratory depression
• D. Hypertension

Correct answer: C

Rationale: The correct answer is C, respiratory depression. When a patient is receiving morphine, respiratory depression is the most concerning side effect because it can lead to serious complications, including respiratory arrest and even death. Monitoring the patient's respiratory status is crucial to ensure early detection of any signs of respiratory depression. Choices A, B, and D are incorrect because although hypotension, bradycardia, and hypertension can occur as side effects of morphine, they are not as immediately life-threatening as respiratory depression in this context.

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