Nursing Elites

1. A nurse is reviewing the laboratory values of a client who has diabetic ketoacidosis (DKA). Which of the following findings should the nurse report to the provider?

• A. Potassium 4.2 mEq/L
• B. Glucose 250 mg/dL
• C. Bicarbonate 20 mEq/L
• D. Sodium 135 mEq/L

Correct answer: B

Rationale: The correct answer is B. A glucose level of 250 mg/dL indicates hyperglycemia, which is expected in DKA. However, in the context of DKA management, persistent or worsening hyperglycemia can indicate inadequate treatment response or complications, necessitating further monitoring and intervention. Potassium levels are crucial in DKA due to the risk of hypokalemia, but a level of 4.2 mEq/L is within the normal range. Bicarbonate levels are typically low in DKA, making a value of 20 mEq/L consistent with the condition. Sodium levels of 135 mEq/L are also within normal limits and not a priority for immediate reporting in the context of DKA.

2. A nurse is reviewing the medical history of a client who has angina. Which of the following findings in the client's medical history should the nurse identify as a risk factor for angina?

• A. Hyperlipidemia.
• B. COPD.
• C. Seizure disorder.
• D. Hyponatremia.

Correct answer: A

Rationale: The correct answer is A: Hyperlipidemia. Hyperlipidemia, which is an elevated level of lipids (fats) in the blood, is a well-established risk factor for angina. High levels of lipids can lead to atherosclerosis, a condition where fatty deposits build up in the arteries, reducing blood flow to the heart muscle and increasing the risk of angina. Choice B, COPD (Chronic Obstructive Pulmonary Disease), is not directly linked to an increased risk of angina. COPD primarily affects the lungs and is not a known risk factor for angina. Choice C, Seizure disorder, and Choice D, Hyponatremia (low sodium levels), are also not typically associated with an increased risk of angina. While medical conditions like hypertension, diabetes, and smoking are other common risk factors for angina, hyperlipidemia is specifically known for its impact on blood vessels, making it a key risk factor to identify in a client's medical history.

3. A nurse is assessing a client who is receiving a continuous heparin infusion. Which of the following findings should the nurse report to the provider?

• A. Platelet count of 200,000/mm³
• B. aPTT of 50 seconds
• C. Hemoglobin of 14 g/dL
• D. INR of 1.0

Correct answer: D

Rationale: The correct answer is D because an INR of 1.0 is below the therapeutic range for clients receiving heparin, indicating a potential need for dosage adjustment. Platelet count (choice A) within normal range, aPTT (choice B) within therapeutic range, and hemoglobin level (choice C) are not directly related to the monitoring of heparin therapy and would not require immediate reporting to the provider.

4. A nurse is caring for a client who has anemia and a hemoglobin level of 8 g/dL. Which of the following findings should the nurse expect?

• A. Jaundice.
• B. Bradycardia.
• C. Tachypnea.
• D. Hypertension.

Correct answer: C

Rationale: The correct answer is C: Tachypnea. Anemia leads to decreased oxygen-carrying capacity due to low hemoglobin levels, prompting the body to increase respiratory rate to enhance oxygen uptake. Jaundice (choice A) is associated with liver issues, not anemia. Bradycardia (choice B) and Hypertension (choice D) are not typically expected findings in clients with anemia; instead, tachycardia may occur as the body compensates for the decreased oxygen delivery.

5. Which electrolyte imbalance should be closely monitored in patients on furosemide?

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

Correct answer: A

Rationale: The correct answer is A: Hypokalemia. Furosemide is a loop diuretic that can lead to potassium loss in the body, resulting in hypokalemia. Monitoring potassium levels is crucial in patients on furosemide to prevent complications such as cardiac arrhythmias and muscle weakness. Choice B, hyponatremia, is not typically associated with furosemide use. Hyperkalemia (choice C) and hypercalcemia (choice D) are not commonly linked to furosemide therapy; therefore, they are incorrect choices.

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