Nursing Elites

1. A client is recovering from an acute myocardial infarction that occurred 3 days ago. Which of the following instructions should the nurse include in the care plan?

• A. Perform an ECG every 12 hours.
• B. Place the client in a supine position while resting.
• C. Draw a troponin level every 4 hours.
• D. Obtain a cardiac rehabilitation consultation.

Correct answer: D

Rationale: After an acute myocardial infarction, cardiac rehabilitation is crucial for the client's recovery. It helps improve the client's overall cardiovascular health, reduces the risk of future cardiac events, and promotes a healthy lifestyle. The other options do not directly address the importance of cardiac rehabilitation in the client's recovery process.

2. A healthcare provider is caring for an adolescent who has sickle-cell anemia. Which of the following manifestations indicates acute chest syndrome and should be immediately reported to the provider?

• A. Substernal retractions
• B. Hematuria
• C. Temperature 37.9�C (100.2�F)
• D. Sneezing

Correct answer: A

Rationale: Substernal retractions are a concerning sign of respiratory distress and can indicate acute chest syndrome, a severe complication of sickle-cell anemia. It results from vaso-occlusion in the pulmonary vasculature, leading to impaired oxygenation. Prompt reporting of this symptom is crucial for early intervention to prevent further complications. Hematuria, a high temperature, and sneezing are not specific manifestations of acute chest syndrome and would not warrant immediate notification to the provider in this context.

3. A healthcare professional is reviewing the laboratory results of a client who has rheumatoid arthritis. Which of the following findings should the healthcare professional report to the provider?

• A. WBC count 8,000/mm�
• B. Platelets 150,000/mm�
• C. Aspartate aminotransferase 10 units/L
• D. Erythrocyte sedimentation rate 75 mm/hr

Correct answer: D

Rationale: In clients with rheumatoid arthritis, an elevated erythrocyte sedimentation rate (ESR) is a common finding and indicates inflammation in the body. A high ESR value suggests active disease activity and potential joint damage. Therefore, the healthcare professional should report an ESR of 75 mm/hr to the provider for further evaluation and management of the client's rheumatoid arthritis.

4. A healthcare professional in the emergency department is assessing a client who has a suspected flail chest. Which of the following findings should the professional not expect?

• A. Bradycardia
• B. Cyanosis
• C. Hypotension
• D. Dyspnea

Correct answer: A

Rationale: Bradycardia is not typically associated with a flail chest. Flail chest is characterized by paradoxical chest wall movement, respiratory distress, and hypoxia, but it does not usually cause bradycardia. The other options, such as cyanosis (bluish discoloration of the skin due to poor oxygenation), hypotension (low blood pressure), and dyspnea (difficulty breathing), are commonly seen in patients with flail chest due to the underlying respiratory compromise.

5. What is the primary purpose of a platelet count?

• A. Assessing clot formation potential
• B. Assessing bleeding risk
• C. Detecting antigen-antibody response
• D. Identifying cardiac enzymes presence

Correct answer: B

Rationale: A platelet count is primarily used to assess the risk of bleeding. Platelets play a crucial role in blood clotting, so a low platelet count can lead to an increased risk of bleeding. Monitoring platelet levels helps healthcare providers evaluate a patient's ability to form clots and manage bleeding.

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