Nursing Elites

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

• A. Decreased bilirubin levels
• B. Decreased prothrombin time
• C. Decreased albumin levels
• D. Increased prothrombin time

Correct answer: D

Rationale: In clients with cirrhosis, the liver is unable to produce clotting factors efficiently, leading to impaired clotting function. Therefore, an increased prothrombin time is expected in cirrhosis. Choices A, B, and C are incorrect. Decreased bilirubin levels are not typically seen in cirrhosis; prothrombin time is usually increased, not decreased; and albumin levels are often decreased in cirrhosis due to reduced synthetic liver function.

2. A nurse overhears two assistive personnel (AP) discussing a client in an elevator. What action should the nurse take?

• A. Contact the client's family about the incident.
• B. Notify the client's provider about the incident.
• C. File a complaint with the facility's ethics committee.
• D. Report the incident to the AP's charge nurse.

Correct answer: D

Rationale: The correct action for the nurse to take in this situation is to report the incident to the AP's charge nurse. This is important because discussing a client's information violates confidentiality policies. Contacting the client's family (Choice A) is not appropriate as it may breach confidentiality further. Notifying the client's provider (Choice B) is not the initial action to take in this situation, as addressing it within the facility should come first. Filing a complaint with the facility's ethics committee (Choice C) is not the immediate step and might not directly address the issue at hand.

3. A nurse is caring for a client who is newly diagnosed with pancreatic cancer and has questions about the disease. To research, the nurse should identify which of the following electronic databases has the most comprehensive collection of nursing articles?

• A. MEDLINE
• B. CINAHL
• C. ProQuest
• D. Health Source

Correct answer: B

Rationale: The correct answer is B, CINAHL. CINAHL is specifically dedicated to nursing and allied health literature, making it the most appropriate database for nursing articles and research. It provides a comprehensive collection of nursing-related articles, journals, and research studies, which are essential for evidence-based practice. MEDLINE, on the other hand, is a valuable resource for medical literature but is not as nursing-focused as CINAHL. ProQuest and Health Source cover a wider range of subjects beyond nursing, so they are not as comprehensive when it comes to nursing-specific articles and research. Therefore, for the nurse looking to access a database with a vast collection of nursing articles, CINAHL is the most suitable option.

4. A nurse is teaching a newly licensed nurse about ergonomic principles. Which action by the newly licensed nurse indicates an understanding of the teaching?

• A. Stand with feet together when lifting a client.
• B. Raise the client's head of bed before pulling the client up.
• C. Use a mechanical lift to move a client.
• D. Place a gait belt around the client's chest before assisting the client.

Correct answer: C

Rationale: The correct answer is C: 'Use a mechanical lift to move a client.' Using a mechanical lift is an essential ergonomic principle to prevent injury and ensure safe client handling. Choice A is incorrect because standing with feet together when lifting a client can lead to instability and improper weight distribution. Choice B is incorrect as raising the client's head of bed before pulling the client up does not primarily relate to ergonomic principles. Choice D is incorrect because while using a gait belt is important for assisting clients with mobility, it is not specifically related to ergonomic principles for safe handling.

5. A nurse is providing teaching to a client who has a new prescription for atorvastatin. Which of the following instructions should the nurse include?

• A. Avoid drinking grapefruit juice while taking this medication.
• B. Take this medication with food to prevent stomach upset.
• C. You should take this medication at bedtime.
• D. You should take this medication on an empty stomach.

Correct answer: A

Rationale: The correct answer is A: 'Avoid drinking grapefruit juice while taking this medication.' Grapefruit juice can increase the risk of toxicity when taken with atorvastatin. Choice B is incorrect because atorvastatin should be taken without regard to meals. Choice C is incorrect because atorvastatin can be taken at any time of the day. Choice D is incorrect because atorvastatin does not need to be taken on an empty stomach.

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