Nursing Elites

1. A client with acute kidney injury (AKI) weighing 50kg and having a potassium level of 6.7mEq/L (6.7mmol/L) is admitted to the hospital. Which prescribed medication should the nurse administer first?

• A. Calcium acetate, one tablet by mouth
• B. Sodium polystyrene sulfonate, 15 grams by mouth
• C. Epoetin Alfa, recombinant, 2,500 units subcutaneously
• D. Sevelamer, one tablet by mouth

Correct answer: B

Rationale: In a client with acute kidney injury (AKI) and hyperkalemia, the priority intervention is to lower the potassium level swiftly. Sodium polystyrene sulfonate is a medication used to treat hyperkalemia by exchanging sodium ions for potassium ions in the intestines, reducing the overall potassium levels. Calcium acetate, epoetin alfa, and sevelamer are not indicated for the immediate reduction of potassium levels in hyperkalemia. Calcium acetate is used to control phosphate levels, epoetin alfa is a medication to treat anemia by stimulating red blood cell production, and sevelamer is a phosphate binder used in chronic kidney disease to reduce phosphate levels.

2. The nurse is teaching the main principles of hemodialysis to a client with chronic kidney disease. Which statement by the client indicates a need for further teaching by the nurse?

• A. My sodium level changes due to the movement from the blood into the dialysate.
• B. Dialysis works by the movement of wastes from higher to lower concentration.
• C. Extra fluid can be pulled from the blood by osmosis.
• D. The dialysate is similar to blood but without any toxins.

Correct answer: B

Rationale: The correct answer is B because dialysis works by the movement of solutes from an area of higher concentration to an area of lower concentration, which is known as diffusion. The other statements are accurate: A correctly describes the movement of sodium during hemodialysis, C explains the removal of excess fluid by osmosis, and D highlights the purpose of the dialysate in removing toxins from the blood.

3. A client with functional urinary incontinence is being taught by a nurse. Which statement should the nurse include in this client’s teaching?

• A. Clean around your catheter daily with soap and water.
• B. Wash the vaginal weights with a 10% bleach solution after each use.
• C. Informing about available operations to repair your bladder.
• D. Buy slacks with elastic waistbands that are easy to pull down.

Correct answer: D

Rationale: Functional urinary incontinence is not related to bladder issues but rather to difficulties with ambulation or accessing the toilet. The goal is to help the client manage clothing independently. Elastic waistband slacks that are easy to pull down facilitate timely access to the toilet. Choices A and B are unrelated and not applicable to functional urinary incontinence. Choice C is incorrect as surgeries to repair the bladder are not indicated for functional urinary incontinence.

4. A woman has been scheduled for a routine mammogram. What should the nurse tell the client?

• A. That mammography takes about 1 hour
• B. Not to eat or drink on the morning of the test
• C. That there is no discomfort associated with the procedure
• D. That deodorants, powders, or creams used in the axillary or breast area must be washed off before the test

Correct answer: D

Rationale: The correct answer is D. The nurse should instruct the client to avoid using deodorants, powders, or creams on the day of the mammogram. These products used in the axillary or breast area can interfere with the mammogram results and must be washed off before the test. Choices A, B, and C are incorrect because mammography typically takes less than 30 minutes, there is no need for fasting before the test, and some discomfort may be experienced during the procedure.

5. Following the diagnosis of angina pectoris, a client reports being unable to walk up two flights of stairs without pain. Which of the following measures would most likely help the client prevent this problem?

• A. Climb the stairs early in the day.
• B. Rest for at least an hour before climbing the stairs.
• C. Take a nitroglycerin tablet before climbing the stairs.
• D. Lie down after climbing the stairs.

Correct answer: C

Rationale: The correct answer is to take a nitroglycerin tablet before climbing the stairs. Nitroglycerin helps prevent angina by dilating the coronary arteries, which increases blood flow to the heart. This medication can help reduce the chest pain and discomfort experienced during physical exertion. Climing the stairs early in the day (Choice A) does not address the underlying issue of inadequate blood flow to the heart. Resting for at least an hour before climbing the stairs (Choice B) may not be as effective in preventing angina as taking nitroglycerin. Lying down after climbing the stairs (Choice D) does not offer a preventive measure for angina; it is more focused on post-activity rest rather than prevention.

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