Nursing Elites

1. Which of the following diseases or conditions is least likely to be associated with an increased potential for bleeding?

• A. metastatic liver cancer
• B. gram-negative septicemia
• C. pernicious anemia
• D. iron-deficiency anemia

Correct answer: C

Rationale: Pernicious anemia is least likely to be associated with an increased potential for bleeding. Pernicious anemia results from vitamin B12 deficiency due to a lack of intrinsic factor, leading to faulty absorption from the gastrointestinal tract. While pernicious anemia can lead to other health issues, bleeding tendencies are not a primary concern. Metastatic liver cancer (choice A) can cause liver dysfunction leading to decreased synthesis of clotting factors, increasing the risk of bleeding. Gram-negative septicemia (choice B) can lead to disseminated intravascular coagulation (DIC) causing excessive bleeding. Iron-deficiency anemia (choice D) can result in microcytic hypochromic red blood cells, which can impair oxygen transport and lead to tissue hypoxia, but it is not directly associated with a significant potential for bleeding.

2. Following a thyroidectomy, a client is complaining of shortness of breath (SOB) and neck pressure. Which nursing action is the best response?

• A. Stay with the client, remove the dressing, and elevate the head of bed.
• B. Call a code, open the trach set, and position the client supine.
• C. Have the client say "EEE"? to check for laryngeal integrity.
• D. Immediately go to the nurse's station and call the physician

Correct answer: A

Rationale: Correct! The client is displaying signs of respiratory distress after a thyroidectomy. By staying with the client, removing the dressing around the neck, and elevating the head of the bed, the nurse can assess the airway and breathing status more effectively. This immediate action can help alleviate any potential airway obstruction. Choice B is incorrect because calling a code and opening the trach set without initial assessment and basic interventions may delay necessary actions. Choice C is incorrect as having the client say "EEE"? is not as immediate or effective in addressing the respiratory distress. Choice D is incorrect as leaving the client alone and calling the physician without providing immediate assistance can be detrimental in a situation of potential airway compromise.

3. The nurse is caring for a client who is 28 weeks pregnant and complains of swollen hands and feet. Which symptom below would cause the greatest concern?

• A. Nasal congestion
• B. Hiccups
• C. Blood glucose of 150
• D. Muscle spasms

Correct answer: D

Rationale: The correct answer is muscle spasms because they can be indicative of a severe condition like preeclampsia, which is a serious complication during pregnancy characterized by high blood pressure and signs of damage to another organ system, most often the liver and kidneys. Nasal congestion and hiccups are common discomforts during pregnancy and do not pose a severe risk to the client or fetus. A blood glucose level of 150, while slightly elevated, may not be alarming in a pregnant individual and can be managed through dietary modifications or medication adjustments. Muscle spasms, especially in the context of pregnancy, should be taken seriously and thoroughly assessed to rule out any underlying serious conditions.

4. What is the best lab test to diagnose disseminated intravascular coagulation (DIC)?

• A. platelet count
• B. prothrombin time (PT)
• C. partial thromboplastin time (PTT)
• D. D-dimer

Correct answer: D

Rationale: The best lab test to diagnose disseminated intravascular coagulation (DIC) is the D-dimer test. In DIC, numerous small clots form throughout the body and are rapidly broken down. D-dimer measures a specific fibrin split product and is the most specific test for DIC. Platelet count (Choice A) is decreased in DIC due to consumption, but it is not specific for diagnosing DIC. Prothrombin time (PT - Choice B) and partial thromboplastin time (PTT - Choice C) are both elevated in DIC because clotting factors have been used up, but they are not specific for DIC as they can be elevated in other conditions as well.

5. A client with stress incontinence should be advised:

• A. to avoid relying solely on absorbent undergarments.
• B. that Kegel exercises might help.
• C. that effective surgical treatments are available.
• D. that behavioral therapy can be beneficial.

Correct answer: B

Rationale: Kegel exercises, which involve tightening and releasing the pelvic floor muscles, can be beneficial for stress incontinence by strengthening the muscles that control urination. Choice A is incorrect as it is important for the client to know that absorbent undergarments can be used as a temporary solution but do not address the underlying issue. Choice C is incorrect as while surgical treatments are available, they are usually considered when conservative treatments like exercises and behavioral therapy have not been successful. Choice D is incorrect as behavioral therapy can be beneficial in managing stress incontinence through lifestyle and dietary modifications, bladder training, and more, contrary to the statement that it is ineffective.

Similar Questions