Nursing Elites

1. How should bleeding in a patient on warfarin be monitored?

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

Correct answer: A

Rationale: The correct answer is to monitor INR levels. INR levels are the most critical indicator for monitoring bleeding risk in patients on warfarin. INR stands for International Normalized Ratio and specifically measures the clotting tendency of the blood. Monitoring hemoglobin levels, potassium levels, or platelet count are not as directly relevant to assessing bleeding risk in patients on warfarin.

2. A healthcare professional is reviewing a client's admission laboratory results. Which of the following findings requires further evaluation?

• A. Sodium 138
• B. Creatinine 1.8
• C. Hemoglobin 15
• D. Potassium 4.2

Correct answer: B

Rationale: The correct answer is B. An elevated creatinine level, such as 1.8, suggests potential kidney dysfunction, requiring further assessment. Sodium level within normal limits (135-145 mEq/L), hemoglobin level of 15 g/dL, and potassium level of 4.2 mEq/L are all within normal ranges and do not indicate immediate concerns. Therefore, they do not require further evaluation at this time.

3. A nurse is caring for a client who is 1 day postoperative following a below-the-knee amputation. Which of the following actions should the nurse take?

• A. Keep the residual limb flat on the bed
• B. Elevate the residual limb on a pillow
• C. Place the client in a prone position for 30 minutes 4 times a day
• D. Keep the residual limb dependent

Correct answer: C

Rationale: The correct action the nurse should take is to place the client in a prone position for 30 minutes four times a day. This position helps prevent contractures after an amputation by stretching the hip flexors and preventing shortening of the residual limb. Keeping the residual limb flat on the bed (Choice A) may lead to contractures. Elevating the residual limb on a pillow (Choice B) can also cause contractures and hinder proper healing. Keeping the residual limb dependent (Choice D) is not recommended as it does not promote proper positioning and circulation.

4. A nurse is assessing a client who has pneumonia. Which of the following findings should the nurse expect?

• A. Bradycardia
• B. Crackles in the lung bases
• C. Dependent edema
• D. Productive cough

Correct answer: C

Rationale: Dependent edema is a common finding in clients with pneumonia due to fluid retention and decreased mobility. Bradycardia (Choice A) is not typically associated with pneumonia. Crackles in the lung bases (Choice B) are more commonly heard in conditions like heart failure or pulmonary edema. A productive cough (Choice D) can be seen in pneumonia but is not as specific as dependent edema.

5. A nurse is providing discharge instructions for a client who has osteoporosis. Which of the following instructions should the nurse include to prevent injury?

• A. Perform weight-bearing exercises.
• B. Avoid crossing the legs beyond the midline.
• C. Avoid sitting in one position for prolonged periods.
• D. Splint the affected area.

Correct answer: A

Rationale: The correct answer is A: Perform weight-bearing exercises. Weight-bearing exercises are crucial for preventing bone density loss in clients with osteoporosis. These exercises help strengthen bones and reduce the risk of fractures. Option B, avoiding crossing the legs beyond the midline, is not directly related to preventing injury in osteoporosis. Option C, avoiding sitting in one position for prolonged periods, is important for preventing pressure ulcers but does not specifically address preventing injury in osteoporosis. Option D, splinting the affected area, is not a standard recommendation for preventing injury in osteoporosis.

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