Nursing Elites

1. A client has undergone renal angiography via the right femoral artery. The nurse determines that the client is experiencing a complication of the procedure upon noting:

• A. Urine output of 40 mL/hr
• B. Blood pressure of 118/76 mm Hg
• C. Respiratory rate of 18 breaths/min
• D. Pallor and coolness of the right leg

Correct answer: D

Rationale: Pallor and coolness of the right leg indicate a potential vascular complication following renal angiography, such as hemorrhage, thrombosis, or embolism. These signs suggest impaired circulation in the affected limb. Urine output, blood pressure, and respiratory rate are not typically associated with complications of renal angiography. Complications of this procedure mainly involve allergic reactions to the dye, dye-induced renal damage, and various vascular issues.

2. The client with diabetes mellitus should be cautioned by the nurse taking a sulfonylurea that alcoholic beverages should be avoided while taking these drugs because they can cause which of the following?

• A. Hypokalemia.
• B. Hyperkalemia.
• C. Hypocalcemia.
• D. Disulfiram (Antabuse)-like symptoms.

Correct answer: D

Rationale: The correct answer is D: Disulfiram (Antabuse)-like symptoms. When a client with diabetes mellitus taking a sulfonylurea consumes alcohol, it can lead to disulfiram-like symptoms, such as nausea, flushing, and palpitations. Choice A, hypokalemia, is incorrect because sulfonylureas do not typically lead to low potassium levels. Choice B, hyperkalemia, is incorrect as sulfonylureas are not associated with high potassium levels. Choice C, hypocalcemia, is also incorrect because sulfonylureas are not known to cause low calcium levels.

3. A client who has undergone pleural biopsy is being monitored by a nurse. Which finding indicates a potential complication for the client?

• A. Warm, dry skin
• B. Mild pain at the biopsy site
• C. Complaints of shortness of breath
• D. Capillary refill time of less than 3 seconds

Correct answer: C

Rationale: Complaints of shortness of breath are a concerning finding post-pleural biopsy, as they may indicate a complication such as a pneumothorax or hemothorax. Shortness of breath can be a sign of respiratory distress that requires immediate attention. Warm, dry skin, mild pain at the biopsy site, and a capillary refill time of less than 3 seconds are not typically associated with immediate complications following a pleural biopsy. Warm, dry skin may be a normal finding, mild pain can be expected at the biopsy site, and a capillary refill time of less than 3 seconds is within normal limits.

4. The nurse assesses a client with advanced cirrhosis of the liver for signs of hepatic encephalopathy. Which finding would the nurse consider an indication of progressive hepatic encephalopathy?

• A. An increase in abdominal girth.
• B. Hypertension and a bounding pulse.
• C. Decreased bowel sounds.
• D. Difficulty in handwriting.

Correct answer: D

Rationale: Difficulty in handwriting is a common early sign of hepatic encephalopathy. Changes in handwriting can indicate progression or reversal of hepatic encephalopathy leading to coma. Choice (A) is a sign of ascites, not hepatic encephalopathy. Hypertension and a bounding pulse (Choice B) are not typically associated with hepatic encephalopathy. Decreased bowel sounds (Choice C) do not directly indicate an increase in serum ammonia level, which is the primary cause of hepatic encephalopathy.

5. Which of the following medications is commonly prescribed for hypertension?

• A. Atenolol
• B. Aspirin
• C. Ibuprofen
• D. Metformin

Correct answer: A

Rationale: The correct answer is Atenolol. Atenolol is a beta-blocker commonly prescribed to manage hypertension due to its ability to reduce the heart rate and lower blood pressure. Options B, C, and D are incorrect because aspirin, ibuprofen, and metformin are not typically used as first-line treatments for hypertension. Aspirin is more commonly used for its antiplatelet effects, ibuprofen is a nonsteroidal anti-inflammatory drug, and metformin is primarily used for managing diabetes.

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