Nursing Elites

1. A healthcare provider is caring for a client who has been diagnosed with sepsis. Which of the following laboratory results indicates that the client is developing disseminated intravascular coagulation (DIC)?

• A. Elevated hemoglobin
• B. Elevated white blood cell count
• C. Decreased fibrinogen level
• D. Decreased platelet count

Correct answer: D

Rationale: The correct answer is D, decreased platelet count. In disseminated intravascular coagulation (DIC), there is widespread activation of clotting factors leading to the formation of multiple blood clots throughout the body, which can deplete platelets. A decreased platelet count is a hallmark of DIC. Elevated hemoglobin (choice A) and elevated white blood cell count (choice B) are not specific indicators of DIC. While fibrinogen levels (choice C) can be decreased in DIC due to consumption, a decreased platelet count is a more specific and early sign of DIC development.

2. A client who is at 12 weeks of gestation and has hyperemesis gravidarum is being cared for by a nurse. Which of the following laboratory values should the nurse report to the provider?

• A. Sodium 140 mEq/L
• B. Potassium 3.8 mEq/L
• C. Blood glucose 90 mg/dL
• D. Urine ketones present

Correct answer: D

Rationale: The correct answer is D: Urine ketones present. The presence of urine ketones indicates dehydration and inadequate glucose control in clients with hyperemesis gravidarum. Reporting this finding to the provider is crucial for prompt intervention to prevent further complications. Choices A, B, and C are within normal ranges and do not directly correlate with the condition of hyperemesis gravidarum. Therefore, they are not the priority values to report in this scenario.

3. A client is 2 hours postoperative following a total knee arthroplasty. Which of the following findings should the nurse report to the provider?

• A. Heart rate 88/min
• B. Capillary refill of 2 seconds
• C. Pain level of 8 on a scale of 0 to 10
• D. Temperature of 37.8°C (100°F)

Correct answer: C

Rationale: A pain level of 8 is high and may indicate inadequate pain control or complications following surgery. Monitoring and managing pain is crucial postoperatively to ensure patient comfort and prevent complications. A heart rate of 88/min, capillary refill of 2 seconds, and a temperature of 37.8°C (100°F) are within normal ranges and do not typically require immediate reporting unless in the context of other concerning signs or symptoms.

4. A nurse is assessing a client who is receiving a blood transfusion. Which of the following findings should the nurse identify as an indication of a hemolytic transfusion reaction?

• A. Low back pain.
• B. Bradycardia.
• C. Chills.
• D. Distended neck veins.

Correct answer: A

Rationale: The correct answer is A: Low back pain. Low back pain is a common sign of a hemolytic transfusion reaction, indicating the destruction of red blood cells. This finding requires immediate intervention as it can lead to serious complications such as renal failure. Bradycardia (choice B) is not typically associated with a hemolytic transfusion reaction. Chills (choice C) can be seen in febrile non-hemolytic transfusion reactions. Distended neck veins (choice D) are more indicative of fluid overload rather than a hemolytic reaction.

5. A nurse is planning care for a client who is receiving total parenteral nutrition (TPN). Which of the following laboratory values should the nurse monitor to evaluate the effectiveness of the therapy?

• A. Serum calcium level
• B. Blood glucose level
• C. Serum albumin level
• D. Serum sodium level

Correct answer: C

Rationale: The correct answer is C, Serum albumin level. Monitoring the serum albumin level helps assess the nutritional effectiveness of total parenteral nutrition (TPN). Serum albumin is a protein that reflects the long-term nutritional status of a patient. Serum calcium level (choice A) is not directly related to TPN effectiveness. Blood glucose level (choice B) is important to monitor in diabetic patients but is not the primary indicator of TPN efficacy. Serum sodium level (choice D) is more related to fluid balance and electrolyte status rather than the effectiveness of TPN.

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