Nursing Elites

1. A healthcare professional is assessing a client who is 24 hours postoperative following an open cholecystectomy. Which of the following findings should the healthcare professional report to the provider?

• A. Urinary output of 100 mL in 4 hours
• B. Serosanguineous wound drainage
• C. Heart rate of 94/min
• D. WBC count of 15,000/mm³

Correct answer: D

Rationale: A WBC count of 15,000/mm³ is elevated and may indicate infection, which should be reported. High WBC count is a sign of inflammation or infection, and in a postoperative client, it can be indicative of surgical site infection or another complication. Urinary output, serosanguineous wound drainage, and a heart rate of 94/min are all within normal ranges for a client post cholecystectomy and do not raise immediate concerns for infection or complications.

2. A nurse is caring for a client who has schizophrenia. Which of the following findings should the nurse expect?

• A. Decreased level of consciousness
• B. Inability to identify common objects
• C. Preoccupation with somatic disturbances
• D. Poor problem-solving ability

Correct answer: B

Rationale: The correct answer is B: Inability to identify common objects. Clients with schizophrenia often experience cognitive deficits, such as difficulty in identifying common objects. This can be attributed to impairments in perception and cognition. Choices A, C, and D are not typically associated with schizophrenia. Decreased level of consciousness is more indicative of conditions like head injuries or metabolic disturbances. Preoccupation with somatic disturbances is commonly seen in somatic symptom disorders, not schizophrenia. Poor problem-solving ability is a characteristic of conditions affecting executive functioning like dementia, rather than schizophrenia.

3. A nurse is assessing a client who is 2 days postoperative following abdominal surgery. Which of the following findings should the nurse report to the provider?

• A. Serosanguineous drainage on the dressing
• B. Heart rate of 88/min
• C. Urine output of 30 mL/hr
• D. Blood pressure of 110/70 mm Hg

Correct answer: C

Rationale: The correct answer is C because a urine output of 30 mL/hr indicates oliguria, which can be a sign of dehydration or kidney impairment postoperatively. This finding should be reported to the provider for further evaluation. Choices A, B, and D are within normal parameters for a client who is 2 days postoperative following abdominal surgery and do not raise immediate concerns. Serosanguineous drainage on the dressing is an expected finding in the early postoperative period, a heart rate of 88/min is within the normal range, and a blood pressure of 110/70 mm Hg is also within normal limits.

4. A client with type 2 diabetes mellitus is scheduled for an arteriogram. Which of the following medications should the nurse instruct the client to discontinue 48 hours prior to the procedure?

• A. Atorvastatin
• B. Digoxin
• C. Nifedipine
• D. Metformin

Correct answer: D

Rationale: The correct answer is D, Metformin. Metformin should be discontinued 48 hours before an arteriogram due to the risk of lactic acidosis. Atorvastatin (Choice A) is a statin used to lower cholesterol levels and is not typically contraindicated before an arteriogram. Digoxin (Choice B) is a medication used for heart conditions and does not need to be discontinued before an arteriogram. Nifedipine (Choice C) is a calcium channel blocker used to treat high blood pressure and angina, and it is not necessary to discontinue before the procedure.

5. A client with chronic kidney disease is being taught by a nurse about managing protein intake. Which of the following instructions should the nurse include?

• A. You should increase your intake of high-protein foods.
• B. You should limit your intake of high-protein foods.
• C. You should avoid all protein sources to prevent further kidney damage.
• D. You should increase your intake of animal protein.

Correct answer: B

Rationale: The correct answer is B: 'You should limit your intake of high-protein foods.' Clients with chronic kidney disease should restrict their intake of high-protein foods to lessen the workload on the kidneys and prevent further kidney damage. Option A is incorrect as increasing intake of high-protein foods can exacerbate the condition. Option C is incorrect as avoiding all protein sources is not advisable, as some proteins are essential for overall health. Option D is incorrect as increasing the intake of animal protein can put more strain on the kidneys due to the metabolites produced during protein breakdown.

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