Nursing Elites

1. A client has a new cast on the left arm, and the nurse is assessing the client. Which of the following findings should the nurse report to the provider immediately?

• A. Increased warmth in the affected arm
• B. Itching under the cast
• C. Pain with passive movement
• D. Drainage on the cast

Correct answer: C

Rationale: The correct answer is C: Pain with passive movement. Pain with passive movement in a client with a new cast can indicate compartment syndrome, a serious condition where pressure builds up within the muscles, nerves, and blood vessels of the affected limb, potentially leading to tissue damage. Immediate reporting is crucial to prevent further complications. Increased warmth in the affected arm could be a normal inflammatory response to the injury and casting process. Itching under the cast is common and can be managed without immediate concern. Drainage on the cast may be expected initially after casting due to residual moisture from the setting process, but ongoing or excessive drainage should be monitored and reported if persistent.

2. Which nutritional assessment data should be collected to best reflect total muscle mass in an adolescent?

• A. Height in inches or centimeters.
• B. Weight in kilograms or pounds.
• C. Triceps skinfold thickness.
• D. Upper arm circumference.

Correct answer: D

Rationale: The correct answer is 'Upper arm circumference.' Upper arm circumference is a better indicator of total muscle mass in adolescents compared to height, weight, or triceps skinfold thickness. Triceps skinfold thickness primarily reflects subcutaneous fat, while weight and height are not specific to muscle mass. Upper arm circumference directly measures the muscle mass in the upper arm and can provide a more accurate assessment in this context. Therefore, choices A, B, and C are incorrect because they do not directly reflect total muscle mass in adolescents.

3. A client with a history of hypertension is taking a beta-blocker. Which side effect should the LPN/LVN monitor for in this client?

• A. Increased appetite
• B. Dry mouth
• C. Bradycardia
• D. Insomnia

Correct answer: C

Rationale: The correct answer is C: Bradycardia. Beta-blockers are medications that can lower heart rate, leading to bradycardia as a potential side effect. It is essential for the LPN/LVN to monitor for this adverse effect due to the medication's mechanism of action. Choices A, B, and D are incorrect because increased appetite, dry mouth, and insomnia are not typically associated with beta-blocker use. Monitoring for bradycardia is crucial to ensure patient safety and to prevent any potential complications.

4. A nurse receives a prescription for an antibiotic for a client with cellulitis. The nurse checks the client’s medical record, discovers the client's allergy to the antibiotic, and calls the provider for a different prescription. Which of the following critical thinking attitudes did the nurse demonstrate?

• A. Fairness
• B. Responsibility
• C. Risk-taking
• D. Creativity

Correct answer: B

Rationale: The nurse demonstrated responsibility by recognizing the potential harm of administering an antibiotic the client is allergic to and taking the necessary steps to ensure the client's safety. Choice A, 'Fairness,' is not applicable in this scenario as it does not involve treating individuals equitably. Choice C, 'Risk-taking,' is incorrect as the nurse's actions aimed to minimize risks rather than taking them. Choice D, 'Creativity,' is not the best fit as the nurse's actions focused on following established protocols and ensuring patient safety rather than thinking innovatively.

5. A nurse is counseling a young adult who describes having difficulty dealing with several issues. Which of the following statements should the nurse identify as the priority to assess further?

• A. “I have my own apartment now, but it’s not easy living away from my guardians.”
• B. “It’s been so stressful for me to even think about having my own family.”
• C. “I don’t even know who I am yet, and now I’m supposed to know what to do.”
• D. “My partner is pregnant, and I don’t think I have what it takes to be a good parent.”

Correct answer: D

Rationale: The statement about feeling unprepared to be a good parent indicates a significant concern that may need further assessment and support. This statement raises issues regarding the individual's readiness for parenthood and potential impact on the partner and the unborn child. Choices A, B, and C, while important, do not present immediate concerns regarding the well-being of another individual and do not raise potential risks that could have a direct impact on others.

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