Nursing Elites

1. The healthcare provider provides instructions to a client with a low magnesium level about the foods that are high in magnesium and tells the client to consume which foods? Select one that does not apply.

• A. Peas
• B. Oranges
• C. Apples
• D. Peanut butter

Correct answer: B

Rationale: Oranges are not high in magnesium. The other choices, such as peas, are good sources of magnesium. Peas, along with cauliflower and canned white tuna, are foods rich in magnesium. Oranges, although healthy, are not known for their high magnesium content.

2. A nurse in the emergency department is performing triage for a group of clients who were in a train crash. Which of the following clients should the nurse tag as emergent?

• A. A client who has an open fracture of the femur
• B. A client who has periorbital ecchymosis
• C. A client who has asymmetrical thorax
• D. A client who has a deep-partial thickness burn on the lower extremities

Correct answer: C

Rationale: In a triage situation, an asymmetrical thorax suggests a potentially life-threatening condition such as a pneumothorax or hemothorax, requiring immediate attention. This client should be tagged as emergent. Periorbital ecchymosis and deep-partial thickness burns, while concerning, may not indicate an immediate life-threatening situation. An open fracture of the femur, although serious, can be prioritized after addressing emergent cases.

3. A client with diabetes experiences Somogyi's effect. To prevent this complication, the nurse should instruct the client to:

• A. Take insulin at 2:00 PM each day
• B. Engage in physical activity daily
• C. Increase the dose of regular insulin
• D. Eat a protein and carbohydrate snack at bedtime

Correct answer: D

Rationale: Somogyi effect, also known as rebound hyperglycemia, occurs as a response to nighttime hypoglycemia. Eating a protein and carbohydrate snack at bedtime can help prevent this by stabilizing blood sugar levels throughout the night. Instructing the client to take insulin at 2:00 PM each day (Choice A) may not directly address the nighttime hypoglycemia concern. Engaging in physical activity daily (Choice B) is generally beneficial for diabetes management but may not specifically prevent Somogyi's effect. Increasing the dose of regular insulin (Choice C) without addressing the nighttime hypoglycemia issue can exacerbate the problem.

4. A nurse is preparing to discharge a client who has end-stage heart failure. The client's partner tells the nurse she can no longer handle caring for the client. Which of the following actions should the nurse take?

• A. Request another family member to assist the client's partner with care
• B. Recommend the partner to place the client in a long-term care facility
• C. Contact the case manager to discuss discharge options
• D. Ask the provider to delay the client's discharge home for a few more days

Correct answer: C

Rationale: The nurse should contact the case manager to discuss discharge options and support the client's partner. This action is appropriate as it involves seeking professional guidance and support for the client's partner who is struggling to care for the client. Option A is not the best choice as it solely focuses on involving another family member without addressing the partner's concerns directly. Option B is premature as recommending long-term care should be a well-considered decision involving multiple healthcare professionals. Option D delays the inevitable without providing a solution to the partner's current challenges.

5. A nurse working on a med-surg unit is managing the care of four clients. The nurse should schedule an interdisciplinary conference for which of the following clients?

• A. A client who is at risk for pressure ulcers and has an albumin level of 4.2 g/dL
• B. A client with type 1 DM who uses an insulin pump
• C. A client who is receiving heparin and has an aPTT of 34 seconds
• D. A client with orthostatic hypotension receiving IV fluids

Correct answer: C

Rationale: The nurse should schedule an interdisciplinary conference for a client who is receiving heparin and has an aPTT of 34 seconds to ensure comprehensive care coordination. In this case, the need for a conference may be to discuss potential adjustments in heparin therapy, monitor for adverse effects, or ensure proper anticoagulation levels. Choices A, B, and D do not specifically indicate the need for interdisciplinary collaboration related to the client's condition or treatment. Therefore, they are not the priority for scheduling an interdisciplinary conference.

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