Nursing Elites

1. 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.

2. Which of the following enzymes is indicative of pancreatitis?

• A. alkaline phosphatase
• B. acid phosphatase
• C. creatine phosphokinase
• D. amylase

Correct answer: D

Rationale: Amylase is elevated in conditions of pancreatic inflammation, such as pancreatitis. Pancreatitis is characterized by the inflammation of the pancreas, leading to the leakage of amylase into the bloodstream. Elevated levels of amylase are a key diagnostic marker for pancreatitis. Alkaline phosphatase is associated with liver and bone conditions, not pancreatitis. Acid phosphatase is more related to prostate health and is not specific to pancreatitis. Creatine phosphokinase is found in tissues like muscle and brain, and elevated levels are seen in conditions like muscle injury or heart attack, not pancreatitis.

3. Which of the following provides the framework for confidentiality and the client's right to privacy?

• A. Health Insurance Portability and Accountability Act
• B. CDC Surveillance Programs
• C. American Nurses Association Code of Ethics
• D. Durable Power of Attorney for Health Care

Correct answer: A

Rationale: The correct answer is the Health Insurance Portability and Accountability Act (HIPAA). HIPAA is the federal statute that outlines client confidentiality and the client's right to privacy. It establishes national standards to protect individuals' medical records and personal health information. The American Nurses Association Code of Ethics emphasizes principles of nursing ethics but does not serve as a legal framework for confidentiality and privacy. CDC Surveillance Programs focus on disease surveillance and control at a public health level and are not directly related to individual client privacy. The durable power of attorney for health care pertains to granting legal decision-making authority to another individual in healthcare matters, rather than addressing confidentiality and privacy rights.

4. The nurse is teaching a client about sleep and gives background information on normal sleep patterns. Which of the following substances promotes sleep?

• A. serotonin
• B. cortisol
• C. alcohol
• D. narcotics

Correct answer: A

Rationale: Serotonin is a substance found in the body that promotes sleep. It plays a role in the synthesis of a hypnogenic factor that directly induces sleep. Cortisol is a stress hormone that can disrupt sleep patterns. Alcohol can disrupt REM sleep and negatively impact sleep quality. Narcotics, like alcohol, can interfere with sleep architecture and lead to poor quality sleep. Therefore, the correct answer is serotonin as it is associated with promoting sleep, while the other substances listed can have negative effects on sleep patterns.

5. Which of the following tests is commonly performed on newborns with jaundice?

• A. blood urea nitrogen
• B. magnesium
• C. bilirubin
• D. prolactin

Correct answer: C

Rationale: The correct answer is C: bilirubin. A high bilirubin level is found in newborns with hepatic immaturity, leading to jaundice. Testing bilirubin levels is crucial in diagnosing and monitoring jaundice in newborns. Choices A, B, and D (blood urea nitrogen, magnesium, and prolactin) are not commonly performed tests for evaluating jaundice in newborns. Blood urea nitrogen is a measure of kidney function, magnesium levels are usually checked in metabolic disorders, and prolactin is a hormone related to lactation, none of which are directly relevant to assessing jaundice in newborns.

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