Nursing Elites

1. A client with osteoporosis is being taught by a nurse how to prevent further bone loss. Which of the following instructions should the nurse include?

• A. Take a calcium supplement daily.
• B. Perform weight-bearing exercises.
• C. Avoid weight-bearing exercises.
• D. Limit intake of high-phosphorus foods.

Correct answer: B

Rationale: The correct answer is B: Perform weight-bearing exercises. Weight-bearing exercises are essential for preventing further bone loss and improving bone density in clients with osteoporosis. Calcium supplements alone may not be sufficient to prevent bone loss without adequate physical activity. Option C, 'Avoid weight-bearing exercises,' is incorrect as these exercises are beneficial for bone health. Option D, 'Limit intake of high-phosphorus foods,' is not directly related to preventing further bone loss in osteoporosis.

2. Four clients present to the emergency department. The nurse should plan to see which of the following clients first?

• A. A 6-year-old client with a dislocated left shoulder
• B. A 26-year-old client with sickle cell disease and severe joint pain
• C. A 76-year-old client who is confused, febrile, and has foul-smelling urine
• D. A 50-year-old client with slurred speech, disorientation, and headache

Correct answer: D

Rationale: The correct answer is D. A client presenting with symptoms of a stroke, such as slurred speech, disorientation, and headache, requires immediate attention due to the possibility of a neurological emergency. Choices A, B, and C, although concerning, do not present with symptoms as urgent as those of a potential stroke. Dislocated shoulder, sickle cell disease with joint pain, and confusion with febrile illness can be addressed after ensuring the client with stroke-like symptoms receives prompt evaluation and intervention.

3. A healthcare professional is receiving a change-of-shift report for an adult female client who is postoperative. Which client information should the healthcare professional report?

• A. Low-grade fever.
• B. Shortness of breath.
• C. Decreased urine output.
• D. High platelet count.

Correct answer: A

Rationale: In a postoperative client, a low-grade fever can be an early sign of infection, which is crucial to report to the healthcare team for timely intervention. Shortness of breath and decreased urine output are also important to monitor, but in the context of postoperative care, infection is a more immediate concern. A high platelet count is not typically a priority in the immediate postoperative period.

4. A nurse is reviewing the medical record of a client who is receiving heparin to treat deep vein thrombosis (DVT). Which of the following findings should the nurse report to the provider?

• A. aPTT of 38 seconds
• B. Hemoglobin of 15 g/dL
• C. Platelet count of 80,000/mm3
• D. INR of 1.0

Correct answer: C

Rationale: A platelet count of 80,000/mm3 is below the normal range and should be reported to the provider due to the risk of bleeding. Heparin can cause a rare but serious side effect known as heparin-induced thrombocytopenia, leading to a decrease in platelet count and an increased risk of bleeding. The aPTT of 38 seconds, hemoglobin of 15 g/dL, and an INR of 1.0 are within normal ranges and not directly concerning in this scenario. Platelet count is crucial to monitor in clients receiving heparin therapy to ensure adequate clotting function and prevent bleeding complications.

5. A nurse is assessing a client who is 2 days postoperative following abdominal surgery. Which of the following findings should the nurse report to the provider?

• A. Serosanguineous drainage on the dressing
• B. Heart rate of 88/min
• C. Urine output of 30 mL/hr
• D. Blood pressure of 110/70 mm Hg

Correct answer: C

Rationale: The correct answer is C because a urine output of 30 mL/hr indicates oliguria, which can be a sign of dehydration or kidney impairment postoperatively. This finding should be reported to the provider for further evaluation. Choices A, B, and D are within normal parameters for a client who is 2 days postoperative following abdominal surgery and do not raise immediate concerns. Serosanguineous drainage on the dressing is an expected finding in the early postoperative period, a heart rate of 88/min is within the normal range, and a blood pressure of 110/70 mm Hg is also within normal limits.

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