Nursing Elites

1. A nurse is reviewing laboratory results for a client who has rheumatoid arthritis and is prescribed methotrexate. Which of the following results should the nurse report to the provider?

• A. White blood cell count 8,000/mm³
• B. Platelet count 150,000/mm³
• C. Hemoglobin 14 g/dL
• D. Aspartate aminotransferase (AST) 60 units/L

Correct answer: D

Rationale: The correct answer is D: Aspartate aminotransferase (AST) 60 units/L. An elevated AST level indicates liver damage, which can be a side effect of methotrexate and should be reported. Elevated white blood cell count (choice A), platelet count (choice B), or normal hemoglobin level (choice C) are not directly related to methotrexate therapy for rheumatoid arthritis.

2. During an in-service about nursing leadership, what information should the nurse include about an effective leader?

• A. Acts as an advocate for the nursing unit.
• B. Prioritizes staff requests over client needs.
• C. Shares personal opinions to influence the group's values.
• D. Provides routine client care and documentation.

Correct answer: A

Rationale: An effective leader advocates for the unit's success and its members. Choice B is incorrect because prioritizing staff requests over client needs does not align with effective leadership, which should focus on client-centered care. Choice C is incorrect as sharing personal opinions to influence the group's values can be biased and may not reflect the best interest of the team. Choice D is incorrect because while providing client care is essential, effective leadership involves more than routine tasks and includes guiding and supporting the team.

3. A healthcare professional is reviewing the medical record of a client with schizophrenia. Which of the following findings should the professional report to the provider?

• A. Blood pressure: 102/56 mm Hg.
• B. Heart rate: 95/min.
• C. Sore throat.
• D. WBC count 14,000/mm^3.

Correct answer: D

Rationale: An elevated WBC count should be reported to the provider as it may indicate an infection. Elevated white blood cell counts can be a sign of an underlying infection or inflammation. Monitoring and reporting abnormal laboratory values are essential for timely interventions. The other options, such as blood pressure, heart rate, and a sore throat, while important for overall assessment, are not directly related to the potential medical urgency indicated by an elevated WBC count.

4. What is the priority intervention for a patient with a severe allergic reaction?

• A. Administer epinephrine
• B. Administer corticosteroids
• C. Administer oxygen
• D. Administer antihistamines

Correct answer: A

Rationale: The correct answer is to administer epinephrine. Epinephrine is the first-line treatment for severe allergic reactions because it rapidly reverses the symptoms of anaphylaxis by constricting blood vessels, increasing heart rate, and relaxing airway muscles. Corticosteroids, although helpful to reduce inflammation, are not the priority in the acute management of severe allergic reactions. Oxygen may be needed to support breathing, but it is not the initial priority. Antihistamines are not as effective as epinephrine in treating severe allergic reactions and should not be the first intervention.

5. Which medication is used to manage hyperthyroidism?

• A. Levothyroxine
• B. Methimazole
• C. Propylthiouracil
• D. Prednisone

Correct answer: B

Rationale: Methimazole is the correct answer. It is commonly used to manage hyperthyroidism by inhibiting the production of thyroid hormones. Levothyroxine (Choice A) is actually a medication used to treat hypothyroidism by supplementing thyroid hormones. Propylthiouracil (Choice C) is another anti-thyroid medication used in the management of hyperthyroidism. Prednisone (Choice D) is a corticosteroid and is not typically used in the treatment of hyperthyroidism.

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