Nursing Elites

1. The nurse is caring for a client with hyperemesis gravidarum. What is the most likely electrolyte imbalance?

• A. Hypocalcemia
• B. Hypomagnesemia
• C. Hyponatremia
• D. Hypokalemia

Correct answer: D

Rationale: In hyperemesis gravidarum, where the client experiences severe nausea and vomiting, the most likely electrolyte imbalance is hypokalemia. Potassium is abundant in the stomach, and excessive vomiting leads to potassium loss. Hypocalcemia (Choice A) is not typically associated with hyperemesis gravidarum. Hypomagnesemia (Choice B) and Hyponatremia (Choice C) are less likely to occur compared to hypokalemia in this condition.

2. Which symptoms is the client who overdosed on barbiturates most likely to exhibit?

• A. Bradypnea and bradycardia
• B. Hyperthermia and drowsiness
• C. Hyperreflexia and slurred speech
• D. Tachycardia and psychosis

Correct answer: A

Rationale: The correct answer is bradypnea and bradycardia. Barbiturates are central nervous system (CNS) depressants, which will slow down the respiratory rate (bradypnea) and heart rate (bradycardia). Choice B, hyperthermia and drowsiness, is incorrect as barbiturate overdose typically does not cause hyperthermia but rather hypothermia. Hyperreflexia and slurred speech (Choice C) are more indicative of stimulant overdoses rather than CNS depressants like barbiturates. Tachycardia and psychosis (Choice D) are also not typically seen in barbiturate overdose, as these drugs tend to depress the CNS rather than cause symptoms of increased heart rate or psychosis.

3. The drug of choice to decrease uric acid levels is:

• A. prednisone (Colisone)
• B. allopurinol (Zyloprim)
• C. indomethacin (Indocin)
• D. hydrochlorothiazide (HydroDiuril)

Correct answer: B

Rationale: The correct answer is allopurinol (Zyloprim) as it is a xanthine oxidase inhibitor that decreases uric acid formation. Allopurinol is commonly used to manage gout by lowering uric acid levels. Prednisone is a corticosteroid used to decrease inflammation, not to lower uric acid levels. Indomethacin is an analgesic, anti-inflammatory, and antipyretic agent, but it is not the drug of choice for lowering uric acid levels. Hydrochlorothiazide is a thiazide diuretic used to treat hypertension and edema, not to decrease uric acid levels.

4. The nurse is caring for a client with full-thickness burns to the left arm and trunk. What is the priority for this client?

• A. Pain management
• B. Airway assessment
• C. Fluid volume status monitoring
• D. Risk for infection prevention

Correct answer: C

Rationale: Correct! With full-thickness burns, there is a significant risk of fluid loss through the burn wound and fluid shift, leading to hypovolemia and shock. Monitoring and maintaining the client's fluid volume status is crucial to prevent complications like hypovolemic shock. Pain management (Option A) is essential but not the priority in this situation. While airway assessment (Option B) is crucial, it is typically assessed first in clients with respiratory distress. Preventing infection (Option D) is important but managing fluid volume status takes precedence in the initial care of a client with full-thickness burns.

5. A 27-year-old woman has delivered twins in the OB unit. The patient develops a condition of 5-centimeter diastasis recti abdominis. Which of the following statements is the most accurate when instructing the patient?

• A. Avoid sit-ups to prevent worsening the condition.
• B. Surgery is not always necessary for this condition.
• C. Guarding the abdominal region is important at this time.
• D. Antibiotics are not needed for diastasis recti abdominis.

Correct answer: C

Rationale: After experiencing diastasis recti abdominis, it is crucial for the patient to protect and guard the abdominal region to facilitate healing. Choice A is correct since avoiding sit-ups is important to prevent worsening the condition by increasing intra-abdominal pressure. Choice B is accurate as not all cases of diastasis recti abdominis require surgery; conservative management is often effective. Choice D is also correct as antibiotics are not indicated for diastasis recti abdominis since it is a separation of the abdominal muscles and not an infectious condition.

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