Nursing Elites

1. A nurse is caring for a client who is experiencing alcohol withdrawal. Which of the following interventions should the nurse implement?

• A. Encourage frequent ambulation
• B. Administer lorazepam
• C. Provide a low-calorie diet
• D. Administer insulin as prescribed

Correct answer: B

Rationale: The correct intervention for a client experiencing alcohol withdrawal is to administer lorazepam. Lorazepam, a benzodiazepine, is commonly used to manage the symptoms of alcohol withdrawal by preventing seizures and reducing agitation and anxiety. Encouraging frequent ambulation (choice A) may not be safe during alcohol withdrawal due to potential instability and confusion. Providing a low-calorie diet (choice C) is not a priority during alcohol withdrawal, as the focus is on managing withdrawal symptoms. Administering insulin as prescribed (choice D) is unrelated to managing alcohol withdrawal symptoms.

2. A nurse is caring for a group of clients. Which of the following clients should the nurse assign to an assistive personnel (AP)?

• A. Client who has chronic obstructive pulmonary disease and needs guidance with incentive spirometry
• B. Client who has awoken following a bronchoscopy and requests a drink
• C. Client who had a myocardial infarction 3 days ago and reports chest discomfort
• D. Client who had a cerebrovascular accident 2 days ago and needs help toileting

Correct answer: D

Rationale: The correct answer is D because the client who had a cerebrovascular accident 2 days ago and needs help toileting is stable and the task is appropriate for delegation to an assistive personnel (AP). Choices A, B, and C involve clients with more complex care needs that require the expertise of a nurse. Choice A involves providing guidance with incentive spirometry, which requires specialized knowledge and assessment skills. Choice B involves a client who has just undergone a bronchoscopy, so close monitoring is essential to assess for any complications. Choice C involves a client who had a myocardial infarction 3 days ago and is reporting chest discomfort, which could indicate a potential cardiac issue requiring immediate nursing assessment and intervention.

3. A nurse is assessing a newborn and notes that the infant has yellow-tinged skin. Which of the following is the priority nursing action?

• A. Assess the infant's bilirubin levels
• B. Initiate phototherapy
• C. Monitor the infant's temperature
• D. Encourage breastfeeding

Correct answer: A

Rationale: Yellow-tinged skin (jaundice) in a newborn can indicate hyperbilirubinemia. The priority action is to assess the infant's bilirubin levels to determine the severity of the jaundice and the need for further interventions, such as phototherapy. Initiating phototherapy (choice B) is premature without knowing the actual bilirubin levels. Monitoring the infant's temperature (choice C) is important but not the priority in this situation. Encouraging breastfeeding (choice D) is beneficial but not the priority when dealing with jaundice in a newborn.

4. A nurse is reviewing the guidelines for reporting nationally notifiable infectious diseases. What disease should the nurse report to the CDC?

• A. Measles
• B. Hepatitis A
• C. Lyme disease
• D. Zika

Correct answer: C

Rationale: The correct answer is Lyme disease. Lyme disease must be reported to the CDC as it is a nationally notifiable infectious disease. It is spread by ticks and can lead to significant health issues if not monitored. Measles, Hepatitis A, and Zika are also important infectious diseases, but in this case, Lyme disease is the appropriate choice based on the information provided.

5. A nurse is reviewing the laboratory results for a client who has a prescription for filgrastim. The nurse should recognize that an increase in which of the following values indicates a therapeutic effect of this medication?

• A. Erythrocyte count
• B. Neutrophil count
• C. Lymphocyte count
• D. Thrombocyte count

Correct answer: B

Rationale: Filgrastim is used to increase neutrophil production in clients undergoing chemotherapy or with bone marrow suppression. A rise in neutrophil count indicates the medication is working effectively to boost immune response. Choices A, C, and D are incorrect as filgrastim primarily targets neutrophils, not erythrocytes, lymphocytes, or thrombocytes.

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