Nursing Elites

1. During a clinic visit for a sore throat, a client's basal metabolic panel reveals a serum potassium of 3.0 mEq/L. Which intervention should the PN recommend to the client based on this finding?

• A. Increase intake of dried peaches and apricots
• B. Reduce intake of red meats
• C. Encourage use of a soft toothbrush
• D. Force fluid intake to 1500 mL daily

Correct answer: A

Rationale: The correct answer is to recommend increasing the intake of dried peaches and apricots. A serum potassium level of 3.0 mEq/L is considered low. Increasing the intake of potassium-rich foods can help raise the serum potassium level, preventing complications such as muscle weakness and cardiac arrhythmias. Choice B, reducing intake of red meats, is incorrect because red meats are not specifically related to potassium levels. Choice C, encouraging the use of a soft toothbrush, is unrelated to addressing low potassium levels. Choice D, forcing fluid intake to 1500 mL daily, is not the appropriate intervention for low serum potassium; instead, increasing potassium-rich foods is more beneficial.

2. While conducting a mental status examination of a newly admitted male client, the PN notes that his head is lowered, and he shows no emotion or expression when speaking. Based on these observations, what documentation should the PN include?

• A. Impaired verbalization
• B. Depressed mood
• C. Flat affect
• D. Diminished LOC

Correct answer: C

Rationale: The correct answer is C: 'Flat affect.' Flat affect refers to a lack of emotional expression, which the PN observed in the client. This observation is significant as it can provide valuable information for the client's mental health assessment and subsequent care planning. Choice A, 'Impaired verbalization,' does not capture the lack of emotional expression seen in the client. Choice B, 'Depressed mood,' may not accurately reflect the observed behavior of the client. Choice D, 'Diminished LOC,' pertains to the level of consciousness, which was not indicated as being a concern in the scenario provided.

3. To accommodate a patient who is an Orthodox Jew, you would assure that her diet does not include which of the following?

• A. Any combination of meat and milk at the same meal
• B. Fish with scales
• C. Salmon
• D. Grape juice

Correct answer: A

Rationale: The correct answer is A. Orthodox Jewish dietary laws prohibit mixing meat and dairy in the same meal, so to accommodate an Orthodox Jew, you should ensure that their diet does not include any combination of meat and milk at the same meal. Choices B, C, and D are not prohibited in a kosher diet. Fish with scales, including salmon, are typically kosher, and grape juice is also permissible under kosher guidelines if certified. Therefore, options B, C, and D are acceptable in an Orthodox Jewish diet, while option A contradicts their dietary laws.

4. There has been a serious explosion at a local factory, and many of the injured are arriving at the hospital. Which of the following patients should a nurse attend to first?

• A. A 30-year-old male who is able to walk into the hospital on his own but has numerous lacerations on the chest and face
• B. A 45-year-old male who was brought in on a stretcher, has been assessed as having respiration and circulation within normal limits, and can follow simple commands
• C. A 50-year-old woman who can walk but has a broken arm and numerous lacerations
• D. A 19-year-old man who has numerous lacerations all over the body and whose respiration exceeds 30 breaths per minute

Correct answer: D

Rationale: The correct answer is D. The 19-year-old man with a respiration rate exceeding 30 breaths per minute is showing signs of respiratory distress, indicating a potentially life-threatening condition that requires immediate attention. Patients with respiratory distress should be prioritized as it is a critical condition. Choices A, B, and C describe patients with injuries that are less immediately life-threatening or who are more stable based on the provided information, so they can be attended to after the patient with respiratory distress. Therefore, the nurse should attend to the 19-year-old man first to address his respiratory distress and ensure his condition does not deteriorate further.

5. During a fire incident in a long-term care facility's kitchen, which task is most crucial for the PN to perform instead of delegating to UAP?

• A. Close the doors to all residents' rooms
• B. Offer comfort and reassurance to each resident
• C. Identify the method for transporting and evacuating each resident
• D. Provide blankets to each resident for use during evacuation

Correct answer: C

Rationale: During a fire emergency, the most critical task for the PN is to identify the method for transporting and evacuating each resident. This task ensures a safe and organized evacuation plan, which is essential for everyone's safety. Delegating this responsibility to an unlicensed assistive personnel (UAP) may lead to errors or delays in the evacuation process. Closing doors to residents' rooms (Choice A) can help contain the fire but is not as urgent as planning the evacuation. While offering comfort and reassurance (Choice B) is important, it should not take precedence over ensuring a safe evacuation. Providing blankets (Choice D) is helpful but does not directly address the primary concern of safely evacuating residents.

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