Nursing Elites

1. A client receiving opiates for pain management was initially sedated but is no longer sedated after three days. What action should the nurse take?

• A. Initiate additional non-pharmacological pain management techniques.
• B. Notify the provider that a dosage adjustment is needed.
• C. No action is needed at this time.
• D. Contact the provider to request an alternate method of pain management.

Correct answer: C

Rationale: The correct answer is C: No action is needed at this time. Sedation from opiates commonly decreases as the body adjusts to the medication. It is a positive sign that the sedation has resolved, indicating the client is tolerating the current dosage well. Initiating additional non-pharmacological pain management techniques (Choice A) is unnecessary since the current pain management regimen is effective. Notifying the provider for a dosage adjustment (Choice B) is premature and not indicated when the sedation has resolved. Contacting the provider to request an alternate method of pain management (Choice D) is excessive and not warranted in this situation where the client is no longer sedated and the current pain management plan is effective.

2. A healthcare professional is assessing a client for signs of infection. Which of the following findings should the healthcare professional look for?

• A. Increased energy
• B. Fever
• C. Improved appetite
• D. Stable weight

Correct answer: B

Rationale: Corrected Question: A healthcare professional is assessing a client for signs of infection. The correct answer is 'Fever.' Fever is a common sign of infection and indicates an immune response to an invading pathogen. Increased energy (Choice A) is not typically associated with infection, as the body often feels fatigued when fighting an infection. Improved appetite (Choice C) and stable weight (Choice D) are not specific signs of infection and may not necessarily indicate the presence of an infectious process. Therefore, the healthcare professional should focus on monitoring for fever as a key indicator of infection.

3. A nurse is assessing a client who has Clostridium difficile (C. diff) infection. Which infection control measure should the nurse implement?

• A. Wear a face shield when entering the room
• B. Place the client in a private room
• C. Place the client in a negative pressure room
• D. Use alcohol-based hand rub following client care

Correct answer: B

Rationale: The correct answer is to place the client in a private room. Clostridium difficile (C. diff) infection requires contact precautions, which include isolating the client in a private room to prevent the spread of infection to others. Wearing a face shield may be necessary in certain situations for protection but is not the primary measure for C. diff. Placing the client in a negative pressure room is not specifically indicated for C. diff unless the client has additional respiratory issues. Using alcohol-based hand rub following client care is not sufficient for C. diff control; thorough handwashing with soap and water is recommended due to the spore-forming nature of C. diff.

4. A nurse is caring for a client at 32 weeks gestation with a history of cardiac disease. Which position should the nurse recommend to promote optimal cardiac output?

• A. The chest
• B. Standing
• C. Supine
• D. Left lateral

Correct answer: D

Rationale: The left lateral position is the correct choice to promote optimal cardiac output in a pregnant client at 32 weeks gestation with cardiac disease. This position improves venous return and decreases pressure on the vena cava, helping optimize cardiac output. Standing (choice B) would not be recommended as it may decrease venous return. The supine position (choice C) should be avoided in pregnant clients with cardiac disease as it can compress the vena cava, reducing cardiac output and potentially causing hypotension. The chest (choice A) is not a valid position recommendation for optimizing cardiac output in this scenario.

5. A nurse in the telemetry unit is receiving the laboratory findings for an adult male client who is being treated for a myocardial infarction. Which of the following is an expected finding for the client?

• A. Troponin I (TnI) 8 ng/mL
• B. Brain natriuretic peptide (BNP) 10 ng/L
• C. Alanine aminotransferase (ALT) 45 units/L
• D. High-density lipoprotein (HDL) 75 mg/dL

Correct answer: A

Rationale: The correct answer is A. Troponin I is a specific marker for myocardial infarction, and levels of 8 ng/mL are elevated, indicating heart muscle damage. Brain natriuretic peptide (BNP) is more related to heart failure rather than myocardial infarction, making choice B incorrect. Alanine aminotransferase (ALT) is a liver enzyme and not specific to myocardial infarction, so choice C is incorrect. High-density lipoprotein (HDL) is a type of cholesterol and is not typically used to diagnose or monitor myocardial infarction, making choice D incorrect.

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