Nursing Elites

1. An 85-year-old client is diagnosed with hypernatremia due to lack of fluid intake and dehydration. The nurse knows that symptoms of hypernatremia include:

• A. Lack of thirst
• B. Pale skin
• C. Hypertension
• D. Swollen tongue

Correct answer: D

Rationale: Hypernatremia among elderly clients can result from dehydration and insufficient fluid intake, leading to sodium levels above 145 mEq/L. Common symptoms of hypernatremia include mental status changes, a thick or swollen tongue, excessive thirst, and flushed skin. Choice A, 'Lack of thirst,' is incorrect as hypernatremia typically presents with excessive thirst. Choice B, 'Pale skin,' is not a typical symptom of hypernatremia. Choice C, 'Hypertension,' is not a direct symptom of hypernatremia and is more commonly associated with other conditions like hypertension itself.

2. The mother of a newborn infant with hypospadias asks the nurse why circumcision cannot be performed. Which is the most appropriate response by the nurse?

• A. Circumcision will cause an infection.
• B. Circumcision is not performed in a newborn.
• C. Circumcision will cause difficulty with urination.
• D. Circumcision has been delayed to save tissue for surgical repair.

Correct answer: D

Rationale: The reason circumcision is not performed in a newborn with hypospadias is that the dorsal foreskin tissue will be needed for the surgical repair of hypospadias. Delaying circumcision allows for the preservation of tissue that will be crucial for the corrective surgery. This surgical repair is typically done within the first year of life to minimize the psychological impact on the child. Choices A, B, and C are incorrect as they do not address the specific reason for delaying circumcision in this case.

3. A patient with acute dyspnea is scheduled for a spiral computed tomography (CT) scan. Which information obtained by the nurse is a priority to communicate to the health care provider before the CT?

• A. Allergy to shellfish
• B. Apical pulse of 104
• C. Respiratory rate of 30
• D. Oxygen saturation of 90%

Correct answer: A

Rationale: Because iodine-based contrast media is used during a spiral CT, the patient may need to have the CT scan without contrast or be premedicated before injection of the contrast media. The increased pulse, low oxygen saturation, and tachypnea all indicate a need for further assessment or intervention but do not indicate a need to modify the CT procedure.

4. Which topic is most important to include in patient teaching for a 41-year-old patient diagnosed with early alcoholic cirrhosis?

• A. Maintaining good nutrition
• B. Avoiding alcohol ingestion
• C. Taking lactulose (Cephulac)
• D. Using vitamin B supplements

Correct answer: B

Rationale: The most important topic to include in patient teaching for a 41-year-old patient diagnosed with early alcoholic cirrhosis is avoiding alcohol ingestion. Alcohol abstinence is crucial in stopping or reversing the progression of the disease. While maintaining good nutrition, taking lactulose (Cephulac), and using vitamin B supplements are important interventions in managing cirrhosis, abstaining from alcohol is the priority for this patient to prevent further damage to the liver and halt disease progression.

5. Which of the following is the most common type of malignant brain tumor in the United States?

• A. Meningioma
• B. Glioblastoma multiforme
• C. Acoustic neuroma
• D. Pituitary adenoma

Correct answer: B

Rationale: Glioblastoma multiforme is the most common malignant brain tumor in the United States, accounting for a significant portion of cases. It is known for its aggressive nature and poor prognosis. Surgical resection, followed by radiation and chemotherapy, is the standard treatment approach for glioblastoma multiforme. Meningioma, acoustic neuroma, and pituitary adenoma are also types of brain tumors but are not as common as glioblastoma multiforme in the United States.

Similar Questions