Nursing Elites

1. A healthcare professional is reviewing a client's laboratory report and notes that the serum calcium level is 4.0 mg/dL. The healthcare professional understands that which condition most likely caused this serum calcium level?

• A. Prolonged bed rest
• B. Renal insufficiency
• C. Hyperparathyroidism
• D. Excessive ingestion of vitamin D

Correct answer: A

Rationale: Prolonged bed rest can lead to hypocalcemia due to decreased mobility and bone resorption. In this scenario, the low serum calcium level of 4.0 mg/dL is likely a result of decreased bone activity and calcium release due to prolonged bed rest. Renal insufficiency would more likely lead to hypercalcemia due to impaired excretion of calcium by the kidneys. Hyperparathyroidism is characterized by increased calcium levels as a result of excess parathyroid hormone. Excessive ingestion of vitamin D can cause hypercalcemia by increasing intestinal absorption of calcium.

2. Which of the following nursing interventions should be taken for a client who complains of nausea and vomits one hour after taking his glyburide (DiaBeta)?

• A. Administer glyburide again
• B. Administer subcutaneous insulin and monitor blood glucose
• C. Monitor blood glucose closely, and look for signs of hypoglycemia
• D. Monitor blood glucose and assess for signs of hyperglycemia

Correct answer: C

Rationale: After a client complains of nausea and vomits one hour after taking glyburide, the priority nursing intervention should be to monitor blood glucose closely and look for signs of hypoglycemia. Vomiting could indicate that the glyburide was not properly absorbed, potentially leading to hypoglycemia. Administering glyburide again (Choice A) could worsen hypoglycemia. Administering subcutaneous insulin (Choice B) is not appropriate without assessing the blood glucose first. Monitoring for signs of hyperglycemia (Choice D) is not the immediate concern in this situation.

3. A nurse manager observes an assistive personnel (AP) incorrectly transferring a client to the bedside commode. Which of the following should the nurse take first?

• A. Refer the AP to the facility procedure manual
• B. Demonstrate the proper client transfer technique for the AP
• C. Instruct the AP to request assistance when unsure about a task
• D. Help the AP assist the client with the transfer

Correct answer: D

Rationale: The correct first action for the nurse is to ensure the safety of the client by immediately intervening to help the AP with the transfer. This hands-on assistance can prevent any potential harm to the client. Referring the AP to the facility procedure manual (Choice A) might take time and delay the necessary immediate action. Demonstrating the proper technique (Choice B) can be done after ensuring the client's safety. Instructing the AP to request assistance (Choice C) is not the most urgent step when a client's safety is at risk.

4. You are working on a pediatric unit. Which toy or other diversional item or activity is most appropriate for your 18-month-old patient?

• A. Story books
• B. Beach balls
• C. An interactive play session with other children less than 2 years of age
• D. Pickup sticks

Correct answer: B

Rationale: A beach ball is appropriate for an 18-month-old as it is safe and can help with motor skills development. Choice A, storybooks, may not be suitable for this age group due to limited attention span. Choice C involves interaction with other children which may not always be feasible in a healthcare setting. Choice D, pickup sticks, poses a choking hazard and is not suitable for toddlers.

5. A client is preparing for an elective mastectomy. The client is wearing a plain gold wedding band. Which of the following is an appropriate procedure for taking care of this client's ring?

• A. Agree to keep the ring for the client until after surgery
• B. Place the ring in the bag with the client's clothing
• C. Tape the ring securely to the client's finger
• D. Place the client's ring in the facility safe

Correct answer: D

Rationale: In this scenario, placing the client's ring in the facility safe is the most appropriate procedure. This ensures the ring is kept secure and prevents any risk of loss or damage during the surgery. Agreeing to keep the ring for the client could raise concerns about accountability, while placing it in the bag with the client's clothing might lead to misplacement. Taping the ring securely to the client's finger is not recommended as it may hinder blood circulation or cause discomfort.

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