Nursing Elites

1. A nurse is assessing a client who has acute respiratory distress syndrome (ARDS). Which of the following findings should the nurse expect?

• A. Barrel-shaped chest
• B. Bradycardia
• C. Increased respiratory rate
• D. Tracheal deviation

Correct answer: C

Rationale: Corrected Rationale: An increased respiratory rate is a common finding in clients with ARDS as the body attempts to compensate for impaired gas exchange. Barrel-shaped chest (Choice A) is associated with conditions like COPD, not ARDS. Bradycardia (Choice B) is unlikely in ARDS due to the body's compensatory mechanisms to improve oxygenation. Tracheal deviation (Choice D) is not typically seen in ARDS and is more suggestive of other respiratory conditions.

2. A healthcare provider is reviewing the medical record of a client who has Cushing's disease. Which of the following findings should the healthcare provider expect?

• A. Decreased serum glucose level
• B. Increased lymphocyte count
• C. Increased serum potassium level
• D. Decreased serum sodium level

Correct answer: C

Rationale: In Cushing's disease, there is increased cortisol production, which can lead to various metabolic disturbances. One of the common findings is an increased serum potassium level. The other options are incorrect because Cushing's disease typically causes hyperglycemia, not decreased serum glucose levels (A), lymphocytopenia, not increased lymphocyte count (B), and hyponatremia, not decreased serum sodium level (D).

3. A nurse is providing discharge teaching to a client who has a new prescription for nitroglycerin sublingual tablets. Which of the following statements should the nurse include?

• A. Take the medication with food to reduce stomach upset.
• B. Store the medication in a cool, dry place.
• C. Take one tablet every 5 minutes until the pain is relieved, up to three doses.
• D. This medication may cause drowsiness.

Correct answer: C

Rationale: The correct answer is to instruct the client to take one nitroglycerin sublingual tablet every 5 minutes until the pain is relieved, up to three doses. This dosing regimen is essential for managing angina attacks effectively. Choice A is incorrect because nitroglycerin sublingual tablets should be placed under the tongue for rapid absorption, not taken with food. Choice B is incorrect because nitroglycerin tablets should be stored in their original container at room temperature, away from moisture and heat. Choice D is incorrect because nitroglycerin typically does not cause drowsiness as a side effect.

4. When caring for a client with asthma experiencing an acute exacerbation, which medication should the nurse administer first?

• A. Montelukast
• B. Salmeterol
• C. Albuterol
• D. Fluticasone

Correct answer: C

Rationale: During an acute asthma exacerbation, the priority is to quickly relieve bronchoconstriction and improve airflow. Albuterol is a short-acting bronchodilator that acts rapidly to dilate the airways, making it the first-line medication for acute symptom relief. Montelukast is a leukotriene receptor antagonist used for long-term asthma control, not for immediate relief. Salmeterol is a long-acting bronchodilator used for maintenance therapy, not for acute exacerbations. Fluticasone is an inhaled corticosteroid that reduces airway inflammation and is also used for long-term control, not for immediate relief during an exacerbation.

5. A nurse is reviewing the medical record of a client who has a new prescription for enalapril. Which of the following findings should the nurse report to the provider?

• A. Serum potassium 4.0 mEq/L
• B. Sodium 138 mEq/L
• C. Serum creatinine 3.8 mg/dL
• D. Hemoglobin 13 g/dL

Correct answer: C

Rationale: The correct answer is C. An elevated serum creatinine level can indicate impaired kidney function, which is crucial to report before administering enalapril. Enalapril, an ACE inhibitor, can affect kidney function, especially in patients with pre-existing renal impairment. Choices A, B, and D are within normal ranges and do not directly impact the initiation of enalapril therapy.

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