Nursing Elites

1. A nurse is reviewing the laboratory results of a client who has Cushing's disease. The nurse should expect an increase in which of the following laboratory values?

• A. Serum glucose level
• B. Serum potassium level
• C. Serum calcium level
• D. Serum sodium level

Correct answer: A

Rationale: The correct answer is A: Serum glucose level. In Cushing's disease, there is increased cortisol production, leading to elevated blood glucose levels. This occurs due to the role of cortisol in promoting gluconeogenesis and insulin resistance. Choices B, C, and D are incorrect because Cushing's disease is not typically associated with alterations in serum potassium, calcium, or sodium levels.

2. A client with asthma is prescribed a corticosteroid inhaler. Which of the following instructions should the nurse include?

• A. Use the inhaler as needed for acute symptoms.
• B. Rinse the mouth after each use.
• C. Take the medication only during asthma attacks.
• D. Administer a bronchodilator after using the corticosteroid.

Correct answer: B

Rationale: The correct instruction is to rinse the mouth after each use of a corticosteroid inhaler to prevent oral candidiasis (thrush). Choice A is incorrect because corticosteroid inhalers are usually used on a regular schedule to control asthma symptoms, not just for acute symptoms. Choice C is incorrect as corticosteroid inhalers are typically used for long-term management, not just during asthma attacks. Choice D is incorrect as administering a bronchodilator after using a corticosteroid is not a standard practice and is not necessary for the effectiveness of the corticosteroid inhaler.

3. A nurse is caring for a client who has a new diagnosis of rheumatoid arthritis. Which of the following laboratory findings should the nurse expect?

• A. Increased WBC count.
• B. Decreased hemoglobin.
• C. Decreased platelet count.
• D. Positive rheumatoid factor.

Correct answer: D

Rationale: The correct answer is D: Positive rheumatoid factor. A positive rheumatoid factor is a common laboratory finding in clients with rheumatoid arthritis, indicating an autoimmune response. Option A, increased WBC count, is not typically associated with rheumatoid arthritis. Option B, decreased hemoglobin, and option C, decreased platelet count, are not specific laboratory findings for rheumatoid arthritis.

4. A healthcare professional is preparing to administer an intermittent enteral feeding to a client who has an NG tube. Which of the following actions should the healthcare professional take first?

• A. Check the residual volume.
• B. Flush the tube with 0.9% sodium chloride.
• C. Elevate the head of the bed to 45 degrees.
• D. Warm the formula to body temperature.

Correct answer: C

Rationale: Elevating the head of the bed to 45 degrees is the priority action before administering an enteral feeding through an NG tube. This position helps prevent aspiration by promoting proper flow and digestion of the feeding. Checking the residual volume, flushing the tube, and warming the formula are important steps but come after ensuring the client is in the correct position to minimize the risk of complications.

5. A nurse is caring for a client who is 3 days postoperative following a bowel resection. Which of the following findings should the nurse report to the provider?

• A. Heart rate of 80/min
• B. White blood cell count of 9,000/mm3
• C. Temperature of 37.8°C (100°F)
• D. Blood pressure of 118/78 mm Hg

Correct answer: C

Rationale: A temperature of 37.8°C (100°F) should be reported to the provider as it can indicate infection, a common postoperative complication. A normal heart rate of 80/min (Choice A), white blood cell count of 9,000/mm3 (Choice B), and blood pressure of 118/78 mm Hg (Choice D) are within normal ranges and do not necessarily indicate a complication postoperatively.

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