Nursing Elites

1. A healthcare professional is reviewing the lab results of a client with liver disease. Which finding requires immediate intervention?

• A. Elevated bilirubin levels
• B. Low albumin levels
• C. Elevated ammonia levels
• D. Low hemoglobin levels

Correct answer: C

Rationale: Elevated ammonia levels in a client with liver disease can lead to hepatic encephalopathy, requiring immediate intervention. Ammonia is a neurotoxin that can cause cognitive impairment and altered mental status. Elevated bilirubin levels (Choice A) are common in liver disease but do not require immediate intervention. Low albumin levels (Choice B) and low hemoglobin levels (Choice D) are also common in liver disease but do not pose an immediate threat compared to elevated ammonia levels.

2. A client with leukemia is considered for a bone marrow transplant. Which principle of healthcare ethics is being practiced by minimizing harm to the client?

• A. Justice
• B. Beneficence
• C. Nonmaleficence
• D. Autonomy

Correct answer: C

Rationale: The correct answer is C: Nonmaleficence. Nonmaleficence is the ethical principle that focuses on avoiding harm to the patient. In this scenario, by considering a bone marrow transplant for the client with leukemia, healthcare professionals are practicing nonmaleficence by aiming to minimize harm. Choice A, Justice, pertains to fairness in the distribution of resources and decisions, which is not the primary focus in this situation. Choice B, Beneficence, involves promoting the patient's well-being, which is related but not directly addressing the act of minimizing harm. Choice D, Autonomy, refers to respecting the patient's right to make decisions about their own care, which is not the key principle at play when minimizing harm in this context.

3. A public health nurse is developing guidelines for the management of a botulism outbreak. Which of the following information should the nurse include?

• A. High-risk individuals should receive immunoglobulin E (IgE)
• B. Implement airborne precautions for clients who have botulism
• C. Administer an aminoglycoside medication
• D. Rinse skin with soap and water following exposure to the botulism toxin

Correct answer: D

Rationale: The correct answer is D. Rinsing the skin with soap and water following exposure to the botulism toxin is crucial as it helps remove the toxin from the skin, preventing further absorption. Choices A, B, and C are incorrect. Immunoglobulin E (IgE) is not used in the management of botulism. Airborne precautions are not necessary for botulism as it is not transmitted through the air. Aminoglycoside medications are not the treatment of choice for botulism.

4. A client is being prepared for discharge after a stroke. Which of the following interventions should be included in the discharge plan to prevent complications?

• A. Recommend physical therapy to improve mobility
• B. Teach the client how to use an incentive spirometer
• C. Encourage the client to ambulate daily
• D. Provide education on proper medication management

Correct answer: D

Rationale: The correct answer is to provide education on proper medication management. Proper medication management is crucial in reducing the risk of stroke recurrence and ensuring the client adheres to the treatment plan. While physical therapy, incentive spirometer use, and daily ambulation are important aspects of stroke rehabilitation, they are not directly related to preventing complications during the discharge phase.

5. A patient has just undergone a tracheostomy. What is the nurse's priority intervention?

• A. Suction the tracheostomy to maintain a patent airway.
• B. Administer pain medication as prescribed.
• C. Change the tracheostomy dressing every 4 hours.
• D. Monitor the patient's oxygen saturation closely.

Correct answer: A

Rationale: The correct answer is to suction the tracheostomy to maintain a patent airway. After a tracheostomy, the priority intervention is to ensure a clear airway to prevent respiratory distress. Administering pain medication, changing the tracheostomy dressing, and monitoring oxygen saturation are important but are secondary to maintaining a patent airway in a patient who has just undergone a tracheostomy.

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