Nursing Elites

1. A nurse is reviewing the medical record of a client who has a new prescription for enalapril. Which of the following findings should the nurse report to the provider?

• A. Serum potassium 4.0 mEq/L
• B. Sodium 138 mEq/L
• C. Serum creatinine 3.8 mg/dL
• D. Hemoglobin 13 g/dL

Correct answer: C

Rationale: The correct answer is C. An elevated serum creatinine level can indicate impaired kidney function, which is crucial to report before administering enalapril. Enalapril, an ACE inhibitor, can affect kidney function, especially in patients with pre-existing renal impairment. Choices A, B, and D are within normal ranges and do not directly impact the initiation of enalapril therapy.

2. A nurse is caring for a client who has a pulmonary embolism. The nurse should identify which finding as an indication of effective treatment?

• A. A chest x-ray reveals increased density in all lung fields.
• B. The client reports feeling less anxious.
• C. Diminished breath sounds are auscultated bilaterally.
• D. ABG results include a pH of 7.48, PaO2 77 mm Hg, and PaCO2 47 mm Hg.

Correct answer: B

Rationale: The correct answer is B. The client reporting feeling less anxious is a positive indication of effective treatment for a pulmonary embolism. This suggests that the client's condition is improving psychologically. Option A is incorrect because increased density in all lung fields on a chest x-ray may indicate unresolved issues related to the embolism. Option C is incorrect as diminished breath sounds bilaterally suggest a complication or worsening of the condition. Option D is incorrect as ABG results within normal range do not necessarily indicate effective treatment for a pulmonary embolism, as other complications may still be present.

3. Which lab value is critical to monitor in patients receiving warfarin therapy?

• A. Monitor INR
• B. Monitor potassium levels
• C. Monitor platelet count
• D. Monitor sodium levels

Correct answer: A

Rationale: The correct answer is A: Monitor INR. INR (International Normalized Ratio) is crucial to monitor in patients receiving warfarin therapy. INR measures the blood's ability to clot and is used to ensure that patients are within the therapeutic range for warfarin therapy. This is important to prevent both clotting disorders and bleeding complications. Monitoring potassium levels (choice B) is not directly related to warfarin therapy. Platelet count (choice C) and sodium levels (choice D) are important parameters but are not as critical to monitor specifically for patients on warfarin therapy.

4. A patient is receiving chemotherapy and has developed stomatitis. Which of the following dietary recommendations should the nurse make?

• A. Eat salty foods to stimulate salivation.
• B. Avoid spicy foods.
• C. Increase intake of high-fiber foods.
• D. Consume cold foods to soothe the mucosa.

Correct answer: D

Rationale: Correct choice: Consume cold foods to soothe the mucosa. Cold foods can help soothe the mucosa and reduce discomfort for patients with stomatitis caused by chemotherapy.\nIncorrect choices: A) Salty foods may irritate the mucosa further. B) Spicy foods can increase discomfort and irritation. C) High-fiber foods may be rough and abrasive, exacerbating the condition.

5. Which medication is used to reverse the effects of opioid overdose?

• A. Naloxone
• B. Epinephrine
• C. Atropine
• D. Lidocaine

Correct answer: A

Rationale: Naloxone is the correct answer. Naloxone is specifically used to reverse the effects of opioid overdose by binding to opioid receptors and blocking the effects of opioids. Epinephrine is mainly used to treat severe allergic reactions, Atropine is used for certain types of heart conditions and to reduce salivation or respiratory secretions, and Lidocaine is a local anesthetic used for numbing purposes. Therefore, choices B, C, and D are incorrect in the context of reversing opioid overdose.

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