Nursing Elites

1. Which of the following represents a normal serum potassium level?

• A. 1.5 mEq/L
• B. 3.0 mEq/L
• C. 4.0 mEq/L
• D. 6.0 mEq/L

Correct answer: C

Rationale: The correct answer is 4.0 mEq/L. Normal serum potassium levels typically range from 3.5-5.5 mEq/L. Choice A (1.5 mEq/L) is below the normal range, Choice B (3.0 mEq/L) is also below the normal range, and Choice D (6.0 mEq/L) is above the normal range. Therefore, the only option within the normal range is Choice C (4.0 mEq/L).

2. The nurse should teach parents of small children that the most common type of first-degree burn is:

• A. scalding from hot bath water or spills.
• B. contact with hot surfaces such as stoves and fireplaces.
• C. contact with flammable liquids or gases resulting in flash burns.
• D. sunburn from lack of protection and overexposure.

Correct answer: D

Rationale: The correct answer is 'sunburn from lack of protection and overexposure.' First-degree burns primarily affect the outer layer of the skin and are commonly caused by overexposure to the sun without adequate protection, making it a significant concern for parents of small children. Choices A, B, and C describe other types of burns (scalding, contact with hot surfaces, and contact with flammable substances) that can cause more severe burns beyond the first-degree level. It is crucial for parents to be educated about sun safety measures to prevent sunburns in children.

3. A client with leukemia is being considered for a bone marrow transplant. The healthcare team is discussing the risks and benefits of this treatment and other possible treatments with the goal of inflicting the least possible harm on the client. Which principle of healthcare ethics is the team practicing?

• A. Fidelity
• B. Nonmaleficence
• C. Autonomy
• D. Justice

Correct answer: B

Rationale: The correct answer is B: Nonmaleficence. Nonmaleficence is the principle of avoiding harm. In healthcare ethics, practitioners aim not only to do good but also to ensure they do no harm. In this scenario, the healthcare team is discussing treatment options with the intention of inflicting the least harm on the client. Choice A, Fidelity, refers to keeping promises made to clients, families, and healthcare professionals. Choice C, Autonomy, pertains to respecting a person's independence and right to make decisions. Choice D, Justice, involves fairness, equity, and the fair allocation of resources, such as healthcare services.

4. Which fetal heart monitor pattern can indicate cord compression?

• A. variable decelerations
• B. early decelerations
• C. bradycardia
• D. tachycardia

Correct answer: A

Rationale: Variable decelerations can indicate cord compression as they are caused by umbilical cord compression or prolapse. This pattern shows an abrupt decrease in heart rate with an erratic shape, often resembling a V or W. Early decelerations (choice B) are typically caused by head compression during contractions and are considered benign. Bradycardia (choice C) is a consistent low heart rate below 110 bpm and is not specific to cord compression. Tachycardia (choice D) is an abnormally high heart rate above 160 bpm and is not associated with cord compression.

5. Which of these clients should the LPN/LVN see first?

• A. a client with a newly placed NG tube who is complaining of pain around the face and a plugged nose
• B. a post-op prostatectomy client who complains of bladder spasms and blood in his foley bag
• C. a client in an arm cast who is 2 days post-op and reports feelings of numbness and tingling in her affected arm
• D. a client newly diagnosed with Hepatitis A who reports stomach pain and itchy skin

Correct answer: C

Rationale: Numbness and tingling hours or days after a cast is applied may indicate compartment syndrome and should be reported to a medical provider right away. This is a potential emergency situation that requires immediate attention to prevent complications. The other options present expected or typical symptoms related to their diagnosis, which do not require immediate intervention. Complaints related to a newly placed NG tube such as pain around the face and a plugged nose may require assessment and intervention but are not as urgent as potential compartment syndrome. Bladder spasms and blood in the foley bag post-prostatectomy are common postoperative issues that can be addressed after the client in the arm cast with potential compartment syndrome is seen. Stomach pain and itchy skin in a client with Hepatitis A are common symptoms of the condition and do not indicate an emergency situation.

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