Nursing Elites

1. A healthcare professional is preparing to discharge a client who is immunocompromised. Which of the following vaccines should the professional plan to administer?

• A. Varicella
• B. Influenza
• C. Hepatitis B
• D. Pneumococcal polysaccharide

Correct answer: D

Rationale: Immunocompromised clients have weakened immune systems, making them more susceptible to infections. The pneumococcal polysaccharide vaccine is recommended for these individuals to help prevent pneumococcal infections, which can be severe and life-threatening. Varicella, Influenza, and Hepatitis B vaccines are not specifically indicated for immunocompromised clients. Varicella contains a live virus that can cause infections in immunocompromised individuals. Influenza is generally recommended for all individuals over 6 months of age but does not have the same priority as the pneumococcal vaccine for immunocompromised clients. Hepatitis B vaccine is crucial for preventing Hepatitis B infection but is not directly related to the increased infection risk faced by immunocompromised clients.

2. A client who is postpartum is being taught about breast care by a nurse. Which of the following statements by the client indicates an understanding of the teaching?

• A. I will wear tight-fitting bras to reduce discomfort
• B. I will nurse my baby frequently to prevent engorgement
• C. I will pump my breasts every 4 hours
• D. I will avoid nursing for at least 48 hours

Correct answer: B

Rationale: The correct answer is B. Nursing the baby frequently helps prevent engorgement and discomfort in breastfeeding mothers. Choice A is incorrect because tight-fitting bras can lead to clogged milk ducts and worsen discomfort. Choice C may lead to oversupply issues and is not necessary unless there is a specific indication. Choice D is incorrect as avoiding nursing for extended periods can lead to engorgement and decreased milk supply.

3. How should a healthcare professional manage a patient with fluid volume deficit?

• A. Encourage oral fluid intake
• B. Administer IV fluids as ordered
• C. Monitor urine output and check electrolyte levels
• D. Monitor skin turgor and capillary refill

Correct answer: A

Rationale: Encouraging oral fluid intake is a crucial nursing intervention in managing a patient with fluid volume deficit. By encouraging oral fluid intake, the patient can increase hydration levels, helping to correct the deficit. Administering IV fluids may be necessary in severe cases or when the patient is unable to tolerate oral intake. Monitoring urine output and checking electrolyte levels are essential aspects of assessing fluid volume status, but they are not direct interventions for correcting fluid volume deficit. Monitoring skin turgor and capillary refill are important assessments for fluid volume status but are not direct management strategies.

4. How should a healthcare professional assess a patient with hyperkalemia?

• A. Monitor ECG and administer insulin
• B. Monitor blood glucose levels and provide fluids
• C. Monitor for muscle weakness and administer calcium gluconate
• D. Monitor electrolyte levels and provide potassium supplements

Correct answer: A

Rationale: Corrected Question: When assessing a patient with hyperkalemia, monitoring the ECG and administering insulin are crucial steps. Hyperkalemia can affect the heart's function, leading to life-threatening arrhythmias. Monitoring the ECG helps in identifying any cardiac abnormalities associated with high potassium levels. Administering insulin, along with glucose, helps shift potassium from the bloodstream into the cells, temporarily lowering the potassium levels. Choice B is incorrect because monitoring blood glucose levels and providing fluids are not the primary interventions for hyperkalemia. Choice C is incorrect as monitoring for muscle weakness and administering calcium gluconate are not the first-line treatments for hyperkalemia. Calcium gluconate may be used in specific situations to stabilize cardiac cell membranes in severe cases of hyperkalemia. Choice D is incorrect because monitoring electrolyte levels and providing potassium supplements would worsen hyperkalemia, as the patient already has elevated potassium levels and does not require additional potassium supplementation.

5. A client has undergone a myelogram, and a nurse is providing post-procedure care. Which action should be included in the nursing care plan?

• A. Encourage ambulation after the procedure
• B. Maintain the prone position for 12 hours
• C. Evaluate the client's distal pulses on the affected side
• D. Encourage oral fluid intake

Correct answer: C

Rationale: The correct action to include in the nursing care plan for a client post-myelogram is to evaluate the client's distal pulses on the affected side. This is crucial to assess circulation and detect any potential complications such as impaired blood flow or vascular issues. Encouraging ambulation after the procedure (Choice A) is not typically recommended immediately post-myelogram, as the client may need to rest. Maintaining the prone position for 12 hours (Choice B) is an outdated practice and is no longer part of standard care post-myelogram. Encouraging oral fluid intake (Choice D) is generally beneficial for hydration but is not a specific priority related to post-myelogram care.

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