Nursing Elites

1. A client who is Rh-negative is being taught about Rh (D) immune globulin by a nurse. Which statement by the client indicates an understanding of the teaching?

• A. If my partner is Rh-negative, I will not receive the shot.
• B. I will receive the shot after delivery if my baby is Rh-negative.
• C. I should not receive any immunizations for 3 months after the shot.
• D. This shot may be given after birth to protect future pregnancies.

Correct answer: D

Rationale: Choice D is the correct answer because it reflects an understanding of Rh immune globulin administration. Rh immune globulin is given after delivery to prevent sensitization in future pregnancies, particularly if the baby is Rh-positive. Choice A is incorrect because Rh-negative partners do not affect the need for Rh immune globulin. Choice B is incorrect as Rh immune globulin is given if the baby is Rh-positive, not Rh-negative. Choice C is incorrect; there is no requirement to avoid immunizations after receiving Rh immune globulin.

2. A nurse is caring for a patient whose family member requests to view the patient’s medical record. What response should the nurse make?

• A. “The patient should provide permission to share the records with you.”
• B. “You can view the records if the provider approves it.”
• C. “I will allow you to see the chart if the patient is unable to give consent.”
• D. “You need to fill out a request form.”

Correct answer: A

Rationale: In this scenario, the nurse should respond by indicating that the patient needs to provide permission to share their medical records with the family member. Patient confidentiality is a fundamental principle in healthcare, and sharing medical records without the patient's consent is a violation of privacy. Choice B is incorrect because the provider's approval alone is not sufficient to share medical records, as patient consent is crucial. Choice C is incorrect because viewing the patient's chart without the patient's consent is not appropriate. Choice D is incorrect as filling out a request form does not address the issue of patient consent, which is essential for sharing medical information.

3. A nurse is reviewing the laboratory results for a client who has end-stage liver disease. Which of the following findings should the nurse expect?

• A. Elevated albumin
• B. Elevated ammonia
• C. Decreased total bilirubin
• D. Decreased prothrombin time

Correct answer: B

Rationale: In end-stage liver disease, the liver's inability to convert ammonia into urea leads to elevated ammonia levels. Elevated ammonia levels can result in hepatic encephalopathy, a serious complication. Therefore, the correct answer is B. Elevated albumin (Choice A) is not typically seen in end-stage liver disease as liver dysfunction often leads to decreased albumin levels. Decreased total bilirubin (Choice C) is unlikely in end-stage liver disease, as bilirubin levels tend to be elevated due to impaired liver function. Decreased prothrombin time (Choice D) is also not expected in end-stage liver disease, as impaired liver function results in prolonged prothrombin time.

4. A nurse is caring for a client prescribed gabapentin. Which of the following should the nurse monitor?

• A. Liver function tests
• B. Renal function
• C. Blood glucose levels
• D. Cardiac rhythm

Correct answer: B

Rationale: The correct answer is B: Renal function. Gabapentin is primarily eliminated by the kidneys, so monitoring renal function is essential to ensure the drug is being cleared effectively from the body. Monitoring liver function tests (choice A) is not a priority for gabapentin as it is not primarily metabolized by the liver. Blood glucose levels (choice C) are not directly impacted by gabapentin. Cardiac rhythm (choice D) monitoring is not typically necessary for clients on gabapentin unless they have pre-existing cardiac conditions that may be exacerbated by the medication.

5. A nurse is caring for a client who has congestive heart failure and is taking digoxin. The client reports nausea and refuses to eat breakfast. Which of the following actions should the nurse take first?

• A. Encourage the client to eat the toast on the breakfast tray
• B. Administer an antiemetic
• C. Inform the client's provider
• D. Check the client's apical pulse

Correct answer: D

Rationale: The correct answer is to check the client's apical pulse first. Nausea can be a sign of digoxin toxicity, and assessing the client's heart rate is crucial in this situation. Administering an antiemetic or encouraging the client to eat should come after ensuring the client's safety. While informing the provider is important, the immediate concern is to assess for potential digoxin toxicity by checking the client's apical pulse.

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