Nursing Elites

1. An adult female client has undergone a routine health screening in the clinic. Which of the following values indicates to the nurse who receives the report of the client’s laboratory work that the client’s hematocrit is normal?

• A. 10%
• B. 22%
• C. 30%
• D. 43%

Correct answer: D

Rationale: The normal hematocrit for an adult female client ranges from 35% to 47%. A hematocrit value of 43% falls within this normal range, indicating normal levels of red blood cells. Choices A, B, and C are low hematocrit values and are considered below the normal range for adult females, signifying potential anemia or other health issues.

2. The nurse is preparing to administer trimethoprim-sulfamethoxazole (TMP-SMX) to a patient who is being treated for a urinary tract infection. The nurse learns that the patient has type 2 diabetes mellitus and takes a sulfonylurea oral antidiabetic drug. The nurse will monitor this patient closely for which effect?

• A. Headaches
• B. Hypertension
• C. Hypoglycemia
• D. Superinfection

Correct answer: C

Rationale: When a patient takes oral antidiabetic agents (sulfonylurea) along with sulfonamides like trimethoprim-sulfamethoxazole, it can lead to an increased hypoglycemic effect. Therefore, the nurse should monitor the patient closely for hypoglycemia. Headaches, hypertension, and superinfection are not typically associated with the interaction between sulfonamides and sulfonylureas. Examples of antidiabetic sulfonylurea medications include glipizide, glimepiride, glyburide, tolazamide, and tolbutamide.

3. Healthcare workers must protect themselves against becoming infected with HIV. The Center for Disease Control has issued guidelines for healthcare workers in relation to protection from HIV. These guidelines include which recommendation?

• A. Place HIV-positive clients in strict isolation and limit visitors.
• B. Wear gloves when coming in contact with the blood or body fluids of any client.
• C. Conduct mandatory HIV testing of those who work with clients with AIDS.
• D. Freeze HIV blood specimens at -70°F to kill the virus.

Correct answer: B

Rationale: The correct answer is B. The CDC guidelines recommend that healthcare workers wear gloves when coming in contact with blood or body fluids from any client since HIV can be infectious before the client becomes aware of their exposure and/or symptomatic. Choice A is incorrect because placing HIV-positive clients in strict isolation and limiting visitors is not a standard practice for HIV infection control. Choice C is incorrect as mandatory HIV testing for those working with AIDS clients is not a CDC recommendation for routine infection control. Choice D is incorrect because freezing HIV blood specimens at -70°F does not kill the virus; HIV can remain infectious even at very low temperatures.

4. When performing a health history on a patient who is to begin receiving a thiazide diuretic to treat heart failure, the nurse will be concerned about a history of which condition?

• A. Asthma
• B. Glaucoma
• C. Gout
• D. Hypertension

Correct answer: C

Rationale: Thiazide diuretics block uric acid secretion, leading to elevated levels that can contribute to gout. Therefore, patients with a history of gout should take thiazide diuretics with caution. Asthma (Choice A), Glaucoma (Choice B), and Hypertension (Choice D) are not directly contraindicated with thiazide diuretics, making choices A, B, and D incorrect.

5. Which of the following is the most important nursing action when administering a blood transfusion?

• A. Monitoring the patient's blood pressure.
• B. Monitoring the patient's temperature.
• C. Monitoring the patient's heart rate.
• D. Monitoring the patient's oxygen saturation.

Correct answer: A

Rationale: The most important nursing action when administering a blood transfusion is monitoring the patient's blood pressure. This is crucial because monitoring blood pressure allows for the prompt identification of any signs of adverse transfusion reactions, such as transfusion reactions or fluid overload. Immediate intervention can be initiated if any complications arise. While monitoring temperature, heart rate, and oxygen saturation are also essential aspects of patient care, they are not as critical as blood pressure monitoring during a blood transfusion. Therefore, the correct answer is to monitor the patient's blood pressure.

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