Nursing Elites

1. A client at risk for developing hyperkalemia states, 'I love fruit and usually eat it every day, but now I can't because of my high potassium level.' How should the nurse respond?

• A. Potatoes and avocados can be substituted for fruit.
• B. If you cook the fruit, the amount of potassium will be lower.
• C. Berries, cherries, apples, and peaches are low in potassium.
• D. You are correct. Fruit is very high in potassium.

Correct answer: C

Rationale: The correct answer is C. Berries, cherries, apples, and peaches are indeed low in potassium, making them suitable choices for someone at risk for hyperkalemia. Choice A is incorrect because potatoes and avocados are high in potassium and should be avoided in this situation. Choice B is incorrect because cooking fruit does not significantly lower its potassium content. Choice D is incorrect as it provides incorrect information, as not all fruits are very high in potassium.

2. A nurse teaches a client who is prescribed a central vascular access device. Which statement should the nurse include in this clients teaching?

• A. You will need to wear a sling on your arm while the device is in place
• B. There is no risk of infection because sterile technique will be used during insertion.
• C. . Ask all providers to vigorously clean the connections prior to accessing the device.
• D. You will not be able to take a bath with this vascular access device.

Correct answer: C

Rationale:

3. A patient admitted with a gastrointestinal bleed and anemia is receiving a blood transfusion. Based on the patient's hypotensive blood pressure, the nurse anticipates an order for IV fluids from the physician. Which of the following IV solutions may be administered with blood products?

• A. D5 and 0.45% Normal Saline
• B. Lactated Ringer's
• C. 5% dextrose in water
• D. 0.9% NaCl

Correct answer: D

Rationale: The correct answer is D: 0.9% NaCl. The only IV solution that can be administered with blood products is normal saline (0.9% NaCl). This solution is compatible with most blood products and is commonly used during transfusions to maintain hemodynamic stability. Choices A, B, and C are incorrect. Choice A, D5 and 0.45% Normal Saline, contains dextrose and is not recommended to be given simultaneously with blood products. Choice B, Lactated Ringer's, contains calcium, which can cause coagulation and should not be mixed with blood. Choice C, 5% dextrose in water, is hypotonic and not suitable to be administered with blood products.

4. A female patient is discharged from the hospital after having an episode of heart failure. She's prescribed daily oral doses of digoxin (Lanoxin) and furosemide (Lasix). Two days later, she tells her community health nurse that she feels weak and her heart 'flutters' frequently. What action should the nurse take?

• A. Tell the patient to rest more frequently.
• B. Advise the patient to discontinue digoxin and contact the physician.
• C. Contact the physician, report the symptoms, and request a blood sample to determine the patient's potassium level.
• D. Instruct the patient to avoid caffeine-containing foods.

Correct answer: C

Rationale: The correct action for the nurse to take is to contact the physician, report the patient's symptoms, and request a blood sample to determine the patient's potassium level. Furosemide, a potassium-wasting diuretic, can lead to hypokalemia, causing weakness and palpitations. Therefore, checking the potassium level is crucial in this situation. Simply telling the patient to rest more frequently won't address the underlying issue of potassium depletion. While digoxin can cause adverse effects, in this case, the symptoms are more likely related to furosemide-induced potassium loss. Instructing the patient to avoid caffeine-containing foods may be beneficial in general, but it wouldn't directly address the potassium depletion that needs urgent attention.

5. A patient with a longstanding diagnosis of generalized anxiety disorder presents to the emergency room. The triage nurse notes upon assessment that the patient is hyperventilating. The triage nurse is aware that hyperventilation is the most common cause

• A. Respiratory acidosis
• B. Respiratory alkalosis
• C. Increased PaCO2
• D. CNS disturbances

Correct answer: B

Rationale:

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