Nursing Elites

1. A healthcare provider is reviewing the medical record of a client who is scheduled for surgery. Which of the following findings should the provider report?

• A. White blood cell count of 8,000/mm³
• B. Potassium level of 4.0 mEq/L
• C. Creatinine level of 1.0 mg/dL
• D. Hemoglobin level of 12 g/dL

Correct answer: C

Rationale: An elevated creatinine level indicates impaired kidney function, which may affect the client's ability to undergo surgery. The other laboratory values (white blood cell count, potassium level, and hemoglobin level) are within normal ranges and do not directly impact the client's readiness for surgery.

2. When providing discharge teaching to a client with diabetes, what is the most important instruction?

• A. Check blood sugar levels once daily
• B. Administer insulin as prescribed before meals
• C. Take medication only when feeling unwell
• D. Eat carbohydrate-rich meals to stabilize blood sugar

Correct answer: B

Rationale: Administering insulin as prescribed before meals is crucial for managing diabetes. This instruction is vital as it helps the client maintain blood sugar levels within the target range. Checking blood sugar levels once daily is important but not as critical as ensuring the timely administration of insulin. Taking medication only when feeling unwell is dangerous as it may lead to uncontrolled blood sugar levels. Eating carbohydrate-rich meals may actually destabilize blood sugar levels rather than stabilizing them, making it an incorrect choice.

3. A client has an NG tube that needs irrigation every 8 hours. Which solution should be used to irrigate the tube to maintain fluid and electrolyte balance?

• A. Tap water
• B. Sterile water
• C. 0.9% sodium chloride
• D. 0.45% sodium chloride

Correct answer: C

Rationale: The correct answer is 0.9% sodium chloride. This solution is isotonic and helps maintain electrolyte balance during irrigation, preventing fluid and electrolyte imbalances. Tap water (choice A) may cause electrolyte imbalances due to its hypotonic nature. Sterile water (choice B) is hypotonic and can lead to electrolyte disturbances. 0.45% sodium chloride (choice D) is hypotonic and may also disrupt electrolyte balance when used for irrigation.

4. A client with an NG tube is reporting nausea and a decrease in gastric secretions. What is the nurse's first action?

• A. Increase the suction pressure
• B. Irrigate the NG tube with sterile water
• C. Turn the client onto their left side
• D. Replace the NG tube with a new one

Correct answer: B

Rationale: The correct first action for a client with an NG tube experiencing nausea and decreased gastric secretions is to irrigate the NG tube with sterile water. This helps alleviate blockages and can improve the client's symptoms. Increasing the suction pressure (Choice A) may exacerbate the issue and cause further discomfort. Turning the client onto their left side (Choice C) is not directly related to addressing the reported symptoms. Replacing the NG tube with a new one (Choice D) should be considered only after attempting initial interventions like irrigation.

5. What is the process for taking a telephone order from a provider?

• A. Patient name, drug, dose, route, frequency
• B. Read back for accuracy
• C. Have a witness listen to the order
• D. Write down the order and follow up

Correct answer: B

Rationale: The correct process for taking a telephone order from a provider involves reading back the information for accuracy. This step ensures that the order is correctly understood and reduces the risk of errors. While listing patient information (Choice A) is essential, it does not encompass the complete process of verifying the order. Having a witness listen to the order (Choice C) may not always be practical or necessary, as direct verification is more efficient. Writing down the order and following up (Choice D) is not as crucial as the immediate read-back process, which allows for real-time clarification and confirmation.

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