Nursing Elites

1. A healthcare provider is assessing a client who has a long arm cast. Which of the following findings indicates a moderate complication when assessing for acute compartment syndrome?

• A. Shortness of breath
• B. Petechiae
• C. Change in mental status
• D. Edema

Correct answer: D

Rationale: Edema is a common sign of acute compartment syndrome, which is a medical emergency caused by increased pressure within a muscle compartment, requiring immediate intervention. Shortness of breath (Choice A) is more indicative of a respiratory issue rather than acute compartment syndrome. Petechiae (Choice B) are pinpoint, round spots that appear on the skin due to bleeding under the skin and are not typically associated with acute compartment syndrome. Change in mental status (Choice C) is more suggestive of neurological issues rather than acute compartment syndrome.

2. A nurse is caring for a client who is postoperative following a thyroidectomy. The client reports tingling in the fingers and around the mouth. The nurse should anticipate which of the following interventions?

• A. Administer calcium gluconate
• B. Provide a high-protein diet
• C. Administer levothyroxine
• D. Apply a warm compress to the client's neck

Correct answer: A

Rationale: Tingling in the fingers and around the mouth is a sign of hypocalcemia, which can occur after thyroid surgery due to accidental damage to the parathyroid glands. Hypocalcemia is common after thyroidectomy due to potential parathyroid damage. Calcium gluconate is the appropriate intervention to treat hypocalcemia. Providing a high-protein diet or administering levothyroxine are not indicated for hypocalcemia. Applying a warm compress to the client's neck would not address the underlying issue of hypocalcemia.

3. A newly licensed nurse tells a charge nurse he is unsure about accepting telephone medication prescriptions. Which of the following providers should the charge nurse identify as having the legal ability to give telephone medication prescriptions?

• A. Nurse midwives
• B. Physical therapists
• C. Pharmacists
• D. Physician assistants

Correct answer: D

Rationale: Physician assistants are healthcare providers who are licensed to prescribe medications. They have the legal ability to give telephone orders for medications. Nurse midwives primarily focus on providing prenatal care and assisting during labor and delivery. Physical therapists specialize in rehabilitation services. Pharmacists dispense medications and provide medication counseling. Therefore, among the options provided, physician assistants are the correct choice for giving telephone medication prescriptions.

4. A client who is being admitted for induction of labor is receiving teaching about newborn safety from a nurse. Which of the following client statements indicates an understanding of the teaching?

• A. I will check the identification badge of anyone who removes my baby from our room.
• B. I should include a photo of my baby along with any public birth announcements on social media.
• C. I will allow my baby to sleep on the bed in my room when I am in the shower.
• D. I should expect the nurses to carry my baby in their arms to the nursery.

Correct answer: A

Rationale: Choice A is the correct answer because the client should verify the identification badge of anyone removing their baby to ensure the infant's safety and prevent abduction. This statement demonstrates an understanding of the importance of strict identification protocols in the hospital setting. Choice B is incorrect because including a photo of the baby in public announcements does not relate to newborn safety teaching. Choice C is incorrect as it is unsafe to allow a baby to sleep on the bed unsupervised. Choice D is incorrect because nurses typically encourage parents to carry their baby to the nursery themselves for bonding and security reasons.

5. Using Naegele's Rule, what is the estimated delivery date for a pregnant client whose last menstrual period was on May 4th, 2013?

• A. January 15, 2014
• B. February 11, 2014
• C. March 3, 2014
• D. December 25, 2013

Correct answer: B

Rationale: Naegele's rule is a standard method for calculating the estimated delivery date (EDD). It involves subtracting three months from the first day of the last menstrual period (LMP), adding seven days, and then adding one year. For a client with an LMP of May 4th, 2013, subtracting three months gives February 4th. Adding seven days results in a due date of February 11th, 2014, which is the correct answer. Choice A (January 15, 2014) is incorrect as it does not account for the full calculation. Choice C (March 3, 2014) is incorrect as it adds too many days in the calculation. Choice D (December 25, 2013) is incorrect as it does not follow the correct steps of Naegele's rule.

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