Nursing Elites

1. A nurse is reviewing the laboratory results for a client who is at 29 weeks of gestation. Which of the following results should the nurse report to the provider?

• A. WBC count 11,000/mm³
• B. Hgb 11.2 g/dL
• C. Hct 34%
• D. Platelets 140,000/mm³

Correct answer: D

Rationale: A platelet count of 140,000/mm³ is at the lower end of the normal range but can be concerning in pregnancy, especially if there are signs of thrombocytopenia or bleeding. Thrombocytopenia in pregnancy can lead to complications such as bleeding during childbirth or excessive bleeding postpartum. The other laboratory values mentioned are within normal ranges for pregnancy and do not typically raise immediate concerns. High WBC counts can be a normal response to pregnancy, hemoglobin levels around 11.2 g/dL and hematocrit levels around 34% are also considered normal in the third trimester.

2. A nurse is assessing a client 1 hour after birth and notes a boggy uterus located 2 cm above the umbilicus. What should the nurse do first?

• A. Take vital signs
• B. Assess lochia
• C. Massage the fundus
• D. Give oxytocin IV bolus

Correct answer: C

Rationale: A boggy uterus located 2 cm above the umbilicus suggests uterine atony, which is a common cause of postpartum hemorrhage. The initial intervention in this situation is to massage the fundus. Fundal massage helps the uterus contract, promoting hemostasis and preventing excessive bleeding. Taking vital signs or assessing lochia are important actions but are secondary to addressing uterine atony. Administering oxytocin IV bolus is often done after fundal massage to further enhance uterine contractions.

3. A nurse is caring for a client with schizophrenia. Which of the following assessment findings should the nurse expect?

• A. Decreased level of consciousness
• B. Inability to identify common objects
• C. Poor problem-solving ability
• D. Preoccupation with somatic disturbances

Correct answer: C

Rationale: Corrected Rationale: Poor problem-solving ability is a common cognitive symptom of schizophrenia. It affects the client's ability to think clearly and make decisions. Decreased level of consciousness (Choice A) is not a typical assessment finding in schizophrenia. Inability to identify common objects (Choice B) is more indicative of conditions like dementia. Preoccupation with somatic disturbances (Choice D) is characteristic of somatic symptom disorders, not schizophrenia.

4. A nurse is caring for a client prescribed montelukast. Which of the following should the nurse include in teaching related to this medication?

• A. Advise the client to take the medication once daily at bedtime.
• B. This medication is for acute management of asthma.
• C. Avoid dairy products while taking this medication.
• D. If the client forgets to take the medication for a few days, he can double up on doses to catch up.

Correct answer: A

Rationale: The correct answer is to advise the client to take the medication once daily at bedtime. Montelukast, a leukotriene modifier, is used for long-term therapy of asthma in adults and children, as well as to prevent exercise-induced bronchospasm. It should be taken once daily in the evening for optimal effectiveness. Choice B is incorrect because montelukast is not for acute management but for long-term therapy. Choice C is incorrect as there is no need to avoid dairy products while taking montelukast. Choice D is incorrect and potentially harmful advice; clients should never double up on doses if they forget to take a medication.

5. A client is being treated with thiazide diuretics. What should the nurse monitor regularly?

• A. Hyperkalemia
• B. Hypokalemia
• C. Hyponatremia
• D. Hypoglycemia

Correct answer: B

Rationale: Thiazide diuretics are known to cause hypokalemia by increasing potassium excretion in the urine. Therefore, the nurse should monitor the client for low potassium levels. Hyperkalemia (Choice A) is not typically associated with thiazide diuretics. Hyponatremia (Choice C) is more commonly linked with thiazide diuretics due to increased sodium excretion. Hypoglycemia (Choice D) is not a usual concern when a client is receiving thiazide diuretics.

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