Nursing Elites

1. A nurse is preparing to discharge a client who has a new diagnosis of chronic kidney disease (CKD). Which of the following referrals should the nurse plan to initiate?

• A. Respiratory therapy
• B. Hospice care
• C. Occupational therapy
• D. Dietary services

Correct answer: D

Rationale: The correct answer is D: Dietary services. Referring the client to dietary services is essential for managing nutrition, including monitoring sodium, potassium, and protein intake, which are crucial aspects of managing chronic kidney disease (CKD). Respiratory therapy (choice A) focuses on managing respiratory conditions, which are not directly related to CKD. Hospice care (choice B) is not appropriate for a new diagnosis of CKD as it is designed for end-of-life care. Occupational therapy (choice C) is beneficial for improving activities of daily living but is not the priority referral for a new CKD diagnosis.

2. A nurse is caring for a client who has increased intracranial pressure (ICP). Which of the following interventions should the nurse implement?

• A. Place several pillows behind the client's head
• B. Place the client in a Sim's position
• C. Keep the client's neck in a midline position
• D. Maintain flexion of the client's hips at a 90° angle

Correct answer: C

Rationale: Keeping the client's neck in a midline position is crucial for managing increased intracranial pressure. This position helps optimize blood flow and minimizes the risk of further increasing ICP. Placing several pillows behind the client's head (Choice A) may inadvertently elevate the head, potentially worsening ICP. Placing the client in a Sim's position (Choice B) or maintaining flexion of the client's hips at a 90° angle (Choice D) are not directly related to managing increased ICP.

3. What is the expected ECG finding in a patient with hypokalemia?

• A. Flattened T waves
• B. Elevated ST segments
• C. Widened QRS complexes
• D. Widened QRS complexes on the ECG

Correct answer: A

Rationale: The correct answer is A: Flattened T waves. In hypokalemia, there is a decrease in serum potassium levels, which can lead to various ECG changes. One of the classic ECG findings associated with hypokalemia is the presence of flattened T waves. These T wave abnormalities are typically seen in multiple leads. Choice B, elevated ST segments, is not a typical ECG finding in hypokalemia. Choice C, widened QRS complexes, is more commonly associated with hyperkalemia rather than hypokalemia. Choice D is redundant and not a standard way of describing ECG findings.

4. What should the nurse monitor for in a patient with hypokalemia?

• A. Monitor for muscle weakness
• B. Check deep tendon reflexes (DTRs)
• C. Monitor for seizures
• D. Monitor for bradycardia

Correct answer: A

Rationale: The correct answer is to monitor for muscle weakness in a patient with hypokalemia. Hypokalemia, which is low potassium levels, can lead to muscle weakness due to its effects on neuromuscular function. Checking deep tendon reflexes (Choice B) is not typically associated with hypokalemia. Seizures (Choice C) are more commonly associated with low calcium levels rather than low potassium levels. Bradycardia (Choice D) is a symptom of hyperkalemia (high potassium levels) rather than hypokalemia.

5. What is the first intervention for a patient admitted with unstable angina?

• A. Administer nitroglycerin
• B. Obtain cardiac enzymes
• C. Start IV fluids
• D. Monitor for chest pain

Correct answer: A

Rationale: The correct first intervention for a patient admitted with unstable angina is to administer nitroglycerin. Nitroglycerin helps to relieve chest pain by dilating blood vessels and increasing blood flow to the heart, thereby reducing cardiac workload. This intervention aims to alleviate symptoms and prevent further cardiac damage. Obtaining cardiac enzymes (Choice B) is important for diagnosing a myocardial infarction but is not the initial intervention for unstable angina. Starting IV fluids (Choice C) may be indicated in specific cases like hypovolemia but is not the primary intervention for unstable angina. Monitoring for chest pain (Choice D) is essential but taking action to alleviate the pain, like administering nitroglycerin, is the primary focus in the initial management of unstable angina.

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