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. In a patient with asthma, which of the following is a primary goal of treatment?

• A. Improving oxygenation.
• B. Reducing inflammation.
• C. Improving airflow.
• D. Reducing airway constriction.

Correct answer: C

Rationale: The primary goal in the treatment of asthma is to improve airflow. Asthma is characterized by airway inflammation, constriction, and increased mucus production, leading to airflow limitation. Improving airflow helps ensure adequate oxygenation and reduces symptoms. While reducing inflammation and airway constriction are important aspects of asthma management, the primary goal is to optimize airflow to improve respiratory function and quality of life.

3. For a client with peripheral vascular disease (PVD) of the lower extremities who is trying to manage their condition well, which routine should the nurse evaluate as appropriate?

• A. Resting with the legs elevated above the level of the heart.
• B. Walking slowly but steadily for 30 minutes twice a day.
• C. Minimizing activity.
• D. Wearing antiembolism stockings at all times when out of bed.

Correct answer: B

Rationale: The correct answer is B. Walking slowly but steadily for 30 minutes twice a day is appropriate for clients with PVD as it helps stimulate collateral circulation and improve blood flow. Choice A is incorrect because while elevating the legs can help with symptoms temporarily, it is not as effective as walking for improving circulation. Choice C, minimizing activity, is not recommended as it can lead to further deconditioning and worsen symptoms. Choice D, wearing antiembolism stockings, is not specifically indicated for PVD and may not address the underlying circulation issues.

4. An overweight client taking warfarin (Coumadin) has dry skin due to decreased arterial blood flow. What should the nurse instruct the client to do? Select all that apply.

• A. Apply lanolin or petroleum jelly to intact skin.
• B. Follow a reduced-calorie, reduced-fat diet.
• C. Inspect the involved areas daily for new ulcerations.
• D. Instruct the client to limit activities of daily living (ADLs).

Correct answer: A

Rationale: To address dry skin and prevent chronic ulcers and infections in an overweight client on warfarin with decreased arterial blood flow, the nurse should instruct the client to apply lanolin or petroleum jelly to intact skin. This helps maintain skin integrity and moisture. Following a reduced-calorie, reduced-fat diet (Choice B) may be beneficial for weight management but is not directly related to skin care. Inspecting involved areas daily for new ulcerations (Choice C) is important for skin assessment and early intervention but does not specifically address dry skin. Instructing the client to limit activities of daily living (ADLs) (Choice D) is not necessary for addressing dry skin; in fact, promoting mobility and circulation through appropriate activities is crucial.

5. Why is the combination drug trimethoprim-sulfamethoxazole (TMP-SMX) necessary?

• A. To broaden the antibacterial spectrum.
• B. To decrease bacterial resistance.
• C. To improve the taste.
• D. To minimize toxic effects.

Correct answer: B

Rationale: The correct answer is B: To decrease bacterial resistance. Trimethoprim-sulfamethoxazole (TMP-SMX) is a combination drug used to prevent bacterial resistance to sulfonamides. It works by targeting different steps in the bacterial metabolic pathway, making it harder for bacteria to develop resistance. Choice A is incorrect because the combination does not broaden the antibacterial spectrum; instead, it enhances effectiveness against specific bacteria. Choice C is incorrect as taste improvement is not the primary reason for combining these drugs. Choice D is incorrect because while combination therapy can sometimes help minimize toxic effects, the primary purpose in this case is to address bacterial resistance.

Similar Questions