Nursing Elites

1. A nurse is providing teaching for a client who is prescribed enoxaparin for DVT prevention. What is an appropriate action by the nurse?

• A. Expel the air bubble from the prefilled syringe
• B. Massage the injection site to distribute the medication
• C. Inject the medication into the lateral abdominal wall
• D. Administer an NSAID for injection site discomfort

Correct answer: C

Rationale: The correct action for a nurse when administering enoxaparin for DVT prevention is to inject the medication into the lateral abdominal wall. This is the recommended site for enoxaparin administration. Expelling the air bubble is unnecessary and may lead to a dosage error. Massaging the injection site is not recommended as it can cause bruising. Administering an NSAID for injection site discomfort is not necessary as discomfort should be minimal and transient.

2. A nurse in an outpatient facility is assessing a client who is prescribed furosemide 40 mg daily, but the client reports she has been taking extra doses to promote weight loss. Which of the following findings indicates she is dehydrated?

• A. Urine specific gravity of 1.020
• B. Urine specific gravity of 1.035
• C. Decreased skin turgor
• D. Decreased heart rate

Correct answer: B

Rationale: The correct answer is B. A urine specific gravity greater than 1.030 is indicative of dehydration as it reflects concentrated urine. Choice A is incorrect as a specific gravity of 1.020 is within the normal range. Choice C, decreased skin turgor, can be a sign of dehydration but is not as specific as urine specific gravity. Choice D, decreased heart rate, is not typically a direct indicator of dehydration.

3. A nurse is caring for a client prescribed prednisone. Which of the following should the nurse monitor?

• A. Blood glucose levels
• B. Serum potassium levels
• C. Liver function tests
• D. Heart rate

Correct answer: A

Rationale: Corrected Rationale: Prednisone is known to cause hyperglycemia by increasing blood glucose levels. Monitoring blood glucose levels is crucial to detect and manage any potential hyperglycemic effects of prednisone. While prednisone can also affect serum potassium levels and liver function, the priority monitoring parameter in this case is blood glucose levels. Monitoring heart rate is not directly associated with prednisone administration, making it a less relevant parameter to monitor in this scenario.

4. A nurse is caring for four clients. Which of the following client data should the nurse report to the provider?

• A. Client who has pleurisy and reports pain of 6 on a scale of 0 to 10
• B. Client with 110 mL of serosanguineous fluid from a Jackson Pratt drain within the first 24 hours after surgery
• C. Client who is 4 hours postoperative and has a heart rate of 98 bpm
• D. Client who has a prescription for chemotherapy and an absolute neutrophil count of 75/mm3

Correct answer: D

Rationale: An absolute neutrophil count of 75/mm3 indicates severe neutropenia, which puts the client at high risk of infection and requires immediate intervention. Neutropenia increases the susceptibility to infections due to a significant decrease in neutrophils, which are essential for fighting off bacteria and other pathogens. Reporting this critical lab value promptly to the provider is essential to ensure appropriate interventions are initiated to prevent life-threatening infections. Choices A, B, and C do not present immediate life-threatening conditions that require urgent reporting to the provider.

5. A client is receiving ferrous sulfate. Which of the following should be monitored?

• A. Serum potassium levels
• B. Hemoglobin levels
• C. Liver function tests
• D. Blood glucose levels

Correct answer: B

Rationale: The correct answer is B: Hemoglobin levels. Ferrous sulfate is used to treat iron deficiency anemia by increasing the body's iron stores. Monitoring hemoglobin levels is crucial as it reflects the effectiveness of the treatment in improving the client's anemia. Serum potassium levels (Choice A) are typically not directly affected by ferrous sulfate. Liver function tests (Choice C) and blood glucose levels (Choice D) are not routinely monitored when a client is receiving ferrous sulfate unless there are specific indications or pre-existing conditions that warrant such monitoring.

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