Nursing Elites

1. A healthcare professional is reviewing the laboratory results of a client who is receiving chemotherapy. Which of the following findings should the healthcare professional report immediately?

• A. White blood cell count of 4,500/mm³
• B. Hemoglobin level of 8 g/dL
• C. Platelet count of 90,000/mm³
• D. Serum potassium level of 3.5 mEq/L

Correct answer: C

Rationale: A platelet count of 90,000/mm³ indicates thrombocytopenia, which increases the risk of bleeding and requires immediate intervention. Thrombocytopenia can lead to serious bleeding complications, so it is crucial to address this finding promptly. A low white blood cell count (choice A) may indicate neutropenia but is not as immediately life-threatening as severe thrombocytopenia. A hemoglobin level of 8 g/dL (choice B) would require intervention but is not as urgent as addressing a critically low platelet count. A serum potassium level of 3.5 mEq/L (choice D) is on the lower side of normal but does not pose an immediate risk to the client's safety compared to severe thrombocytopenia.

2. A client with heart failure is being taught about dietary modifications by a nurse. Which of the following client statements indicates an understanding of the teaching?

• A. I will increase my intake of canned vegetables.
• B. I will limit my daily sodium intake to 2 grams.
• C. I will increase my intake of whole grains.
• D. I will reduce my intake of processed meats.

Correct answer: D

Rationale: The correct answer is 'D: I will reduce my intake of processed meats.' This choice indicates an understanding of the teaching because processed meats are high in sodium, which can worsen heart failure due to fluid retention. Choices A, B, and C do not directly address the issue of reducing sodium intake, which is crucial for clients with heart failure. Increasing canned vegetable intake (A) may not always be advisable due to potential high sodium content in canned products. Limiting sodium intake to 2 grams daily (B) is a good practice, but it's more specific to sodium restriction rather than addressing the source of sodium like processed meats. Increasing whole grains (C) is generally beneficial but does not directly relate to reducing sodium intake in heart failure clients.

3. A nurse is providing dietary teaching to a client with chronic kidney disease. Which of the following foods should the nurse recommend?

• A. Canned soup
• B. Bananas
• C. White bread
• D. Processed meats

Correct answer: C

Rationale: The correct answer is C: White bread. White bread is low in potassium, making it a suitable choice for clients with chronic kidney disease to prevent hyperkalemia. Canned soup (choice A), bananas (choice B), and processed meats (choice D) are high in potassium and should be limited or avoided by individuals with chronic kidney disease to manage their condition effectively.

4. What is the first intervention when a patient has difficulty breathing post-surgery?

• A. Administer oxygen
• B. Reposition the patient
• C. Check oxygen saturation
• D. Elevate the head of the bed

Correct answer: A

Rationale: Administering oxygen is the initial intervention for a patient experiencing breathing difficulties post-surgery. Providing oxygen helps improve oxygenation and alleviate respiratory distress. Repositioning the patient, checking oxygen saturation, and elevating the head of the bed are important interventions but administering oxygen takes precedence in addressing hypoxia and respiratory compromise.

5. A nurse is planning care for a client who has a prescription for a bowel-training program following a spinal cord injury. Which of the following actions should the nurse include in the plan of care?

• A. Encourage a maximum fluid intake of 1,500 ml per day.
• B. Increase the intake of refined grains in the client's diet.
• C. Provide the client with a cold drink prior to defecation.
• D. Administer a rectal suppository 30 minutes prior to scheduled defecation times.

Correct answer: D

Rationale: Administering a rectal suppository 30 minutes before scheduled defecation times is essential in a bowel-training program following a spinal cord injury. The suppository helps stimulate bowel movements and aids in establishing a regular bowel routine. Encouraging a maximum fluid intake of 1,500 ml per day (Choice A) might be beneficial for bowel function, but it is not specific to the bowel-training program. Increasing the intake of refined grains in the diet (Choice B) is not necessary and could potentially lead to constipation rather than improving bowel movements. Providing a cold drink prior to defecation (Choice C) may not directly contribute to the effectiveness of the bowel-training program compared to the use of a rectal suppository.

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