Nursing Elites

1. A nurse in the emergency department is caring for a client who has full-thickness burns of the thorax and upper torso. After securing the client's airway, which of the following is the nurse's priority intervention?

• A. Providing pain management.
• B. Offering emotional support.
• C. Preventing infection.
• D. Initiating IV fluids.

Correct answer: D

Rationale: After securing the airway, initiating IV fluids is the priority to prevent hypovolemic shock in clients with severe burns. IV fluids help maintain circulating volume and prevent a drop in blood pressure due to fluid loss. Providing pain management, offering emotional support, and preventing infection are important aspects of care but are secondary to ensuring adequate fluid resuscitation in clients with severe burns.

2. What should be included in dietary teaching for a client with chronic kidney disease?

• A. Increase potassium-rich foods in the diet
• B. Limit phosphorus and potassium intake
• C. Encourage protein-rich foods to improve nutrition
• D. Increase calcium-rich foods in the diet

Correct answer: B

Rationale: The correct answer is to limit phosphorus and potassium intake for a client with chronic kidney disease. In renal insufficiency, the kidneys struggle to excrete these minerals, leading to their buildup in the blood, which can be harmful. Limiting phosphorus and potassium intake helps prevent further kidney damage and manage the progression of chronic kidney disease. Encouraging protein-rich foods (Choice C) may be counterproductive as excessive protein intake can burden the kidneys. Increasing potassium-rich foods (Choice A) is incorrect as high potassium levels can be detrimental in kidney disease. Increasing calcium-rich foods (Choice D) is not typically a focus in dietary teaching for chronic kidney disease unless there is a specific deficiency or need, as excessive calcium intake can also be harmful to kidney function.

3. A nurse in a long-term care facility is serving on the ethics committee, which is addressing a client care dilemma. Which of the following strategies will facilitate resolving the dilemma?

• A. Ensure client autonomy only
• B. Consider only medical benefits
• C. Ensure clear communication among the health care team
• D. Identify possible solutions

Correct answer: D

Rationale: In resolving ethical dilemmas, it is essential to identify possible solutions to address the client care dilemma effectively. Option A, 'Ensure client autonomy only,' is not comprehensive enough to resolve complex ethical issues. Option B, 'Consider only medical benefits,' overlooks other important factors beyond medical benefits that are involved in ethical decision-making. Option C, 'Ensure clear communication among the health care team,' is important but may not be sufficient on its own to resolve the ethical dilemma. Therefore, the most effective strategy among the given options is to identify possible solutions to navigate through the ethical dilemma.

4. Which of the following is an expected side effect of furosemide?

• A. Bradycardia
• B. Hypokalemia
• C. Increased blood pressure
• D. Increased urine output

Correct answer: B

Rationale: The correct answer is B, Hypokalemia. Furosemide is a loop diuretic that works by increasing the excretion of water and electrolytes, including potassium, leading to hypokalemia. Choice A, Bradycardia, is incorrect because furosemide does not typically cause a decrease in heart rate. Choice C, Increased blood pressure, is incorrect as furosemide is actually used to lower blood pressure by reducing fluid volume. Choice D, Increased urine output, is a common effect of furosemide due to its diuretic action but is not an adverse side effect.

5. How do you assess for dehydration in a pediatric patient?

• A. Check for dry mouth and decreased urine output
• B. Monitor skin turgor and capillary refill
• C. Assess for lethargy and irritability
• D. Monitor blood pressure and heart rate

Correct answer: A

Rationale: Correct! When assessing for dehydration in a pediatric patient, checking for dry mouth and decreased urine output are crucial indicators. Dry mouth indicates reduced fluid intake or dehydration, while decreased urine output suggests decreased renal perfusion secondary to dehydration. Skin turgor and capillary refill are more indicative of perfusion status rather than dehydration specifically. Lethargy and irritability can be present in dehydrated patients but are more general signs of illness. Monitoring blood pressure and heart rate are important in assessing dehydration severity but are not the initial signs used for assessment.

Similar Questions