Nursing Elites

1. A nurse is assessing a client who is 4 hours postoperative following a total hip arthroplasty. Which of the following findings should the nurse report to the provider?

• A. Blood pressure of 118/76 mm Hg
• B. Heart rate of 88/min
• C. Urinary output of 30 mL/hr
• D. Hematocrit 42%

Correct answer: B

Rationale: The correct answer is B: 'Heart rate of 88/min.' A heart rate of 88/min in a postoperative client can be an early sign of bleeding or other complications. It is essential to report this finding promptly to the healthcare provider for further evaluation and intervention. Choices A, C, and D are within normal ranges for a postoperative client and do not indicate immediate concern. A blood pressure of 118/76 mm Hg is normal, urinary output of 30 mL/hr may be adequate depending on the client's fluid status, and a hematocrit of 42% is within the acceptable range for a postoperative client. Therefore, they do not require immediate reporting.

2. What is the best nursing action for a patient experiencing shortness of breath?

• A. Administer oxygen
• B. Administer bronchodilators
• C. Reposition the patient
• D. Provide IV fluids

Correct answer: A

Rationale: Administering oxygen is the best nursing action for a patient experiencing shortness of breath as it helps alleviate the symptoms and improve oxygenation. Providing oxygen addresses the primary issue of inadequate oxygen levels in the body, which can be a life-threatening situation. Administering bronchodilators (choice B) may be appropriate for specific respiratory conditions like asthma but is not the initial intervention for all causes of shortness of breath. Repositioning the patient (choice C) can sometimes help improve breathing, but in a patient experiencing significant shortness of breath, immediate oxygen therapy is crucial. Providing IV fluids (choice D) is not indicated as the first-line intervention for shortness of breath unless there is a specific underlying cause such as dehydration.

3. A nurse is assessing a client who is immediately postoperative following a subtotal thyroidectomy. Which of the following should the nurse expect to administer?

• A. Calcium gluconate
• B. Sodium bicarbonate
• C. Potassium chloride
• D. Sodium phosphate

Correct answer: A

Rationale: Calcium gluconate is the correct answer because it is administered to treat hypocalcemia, a common complication post-thyroidectomy. After a thyroidectomy, there is a risk of damaging the parathyroid glands, which can lead to a decrease in calcium levels. Administering calcium gluconate helps to raise calcium levels. Sodium bicarbonate (Choice B) is not typically indicated for immediate postoperative care following a subtotal thyroidectomy. Potassium chloride (Choice C) is not directly related to the common complications of this specific surgery. Sodium phosphate (Choice D) is not typically used to address immediate postoperative issues post-thyroidectomy.

4. What is the appropriate nursing intervention for a patient with suspected deep vein thrombosis (DVT)?

• A. Administer anticoagulants
• B. Encourage ambulation
• C. Apply compression stockings
• D. Monitor oxygen saturation

Correct answer: A

Rationale: The correct answer is to administer anticoagulants. Anticoagulants help prevent further clot formation in patients with suspected DVT. Encouraging ambulation can be beneficial in preventing DVT but is not the immediate intervention for a suspected case. Compression stockings are more for DVT prevention rather than treatment. Monitoring oxygen saturation is important in assessing respiratory function but is not the primary intervention for suspected DVT.

5. A client with preeclampsia and postpartum hemorrhage is being cared for by a nurse. The nurse should recognize that which of the following medications is contraindicated?

• A. Methylergonovine
• B. Misoprostol
• C. Dinoprostone
• D. Oxytocin

Correct answer: A

Rationale: The correct answer is A, Methylergonovine. Methylergonovine is contraindicated in clients with preeclampsia due to the risk of hypertension. Misoprostol (choice B), Dinoprostone (choice C), and Oxytocin (choice D) are appropriate medications for managing postpartum hemorrhage and are not contraindicated in clients with preeclampsia.

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