Nursing Elites

1. A healthcare professional is reviewing a patient's ECG report. The patient exhibits a flat T wave, depressed ST segment, and short QT interval. Which of the following medications can cause all of the above effects?

• A. Morphine
• B. Atropine
• C. Procardia
• D. Digitalis

Correct answer: D

Rationale: The correct answer is Digitalis. Digitalis is known to cause a flat T wave, depressed ST segment, and a short QT interval on an ECG report. These ECG changes are characteristic of digitalis toxicity. Morphine is not typically associated with these ECG changes. Atropine is more commonly linked to increasing heart rate rather than causing these specific ECG abnormalities. Procardia is a calcium channel blocker that does not typically produce the described ECG findings. Therefore, Digitalis is the most likely medication causing these effects in the patient.

2. Why is starting a low CHO diet a contraindication for a client with renal insufficiency?

• A. As long as the client eats a minimum of 30g of CHO/day, there should be no problem.
• B. The client's clinical condition is a contraindication to starting a low CHO diet.
• C. Calcium supplements should be utilized to prevent the development of osteoporosis while on a low CHO diet.
• D. As long as the client eats foods that are high biologic protein sources, a low CHO diet can be followed.

Correct answer: B

Rationale: A client with renal insufficiency should not start a low CHO diet because it could result in an increased renal solute load. Clients with renal or liver disease require protein control in their diet to prevent complications. Proteins used must be of high biologic value, and protein intake is usually weight-based. Protein levels may be adjusted based on the client's clinical condition. A minimum level of carbohydrates is needed in the diet to spare protein. Vitamin and mineral supplements might be needed for clients with liver failure. The dietician plays a crucial role in calculating specific nutrient requirements for these clients and monitoring outcomes in conjunction with the healthcare team. Choice A is incorrect because simply consuming a minimum amount of carbohydrates does not address the issue of increased renal solute load. Choice C is incorrect as calcium supplements are not the primary concern when considering a low CHO diet for a client with renal insufficiency. Choice D is incorrect as the focus should be on the contraindication of a low CHO diet for a client with renal insufficiency rather than just high biologic protein sources.

3. The client has jaundice, elevated liver enzymes, and an elevated serum bilirubin. What color urine does the nurse expect to find?

• A. Pink-tinged
• B. Straw-colored
• C. Clear
• D. Dark amber

Correct answer: D

Rationale: The correct answer is dark amber. In jaundice, the elevated bilirubin levels are excreted in the urine, giving it a dark amber color. Choices A, B, and C are incorrect because in jaundice, the urine typically appears dark amber due to the presence of elevated bilirubin, not pink-tinged, straw-colored, or clear.

4. A client has been receiving cyanocobalamin (B12) injections for the past 6 weeks. Which laboratory finding indicates that the medication is having the desired effect?

• A. Neutrophil count of 60%
• B. Basophil count of 0.5%
• C. Monocyte count of 2%
• D. Reticulocyte count of 1%

Correct answer: D

Rationale: Cyanocobalamin is a B12 medication used for pernicious anemia. A reticulocyte count of 1% indicates the desired effect of the medication, as reticulocytes are immature red blood cells that increase in response to B12 therapy, improving anemia. Neutrophils, basophils, and monocytes are white blood cells and are not directly influenced by B12 injections, making them incorrect choices.

5. In the treatment of symptomatic bradycardia, which medication is most commonly recognized?

• A. Questran
• B. Digitalis
• C. Nitroglycerin
• D. Atropine

Correct answer: D

Rationale: Atropine is the medication most commonly recognized for the treatment of symptomatic bradycardia because it increases the rate of conduction in the AV node, helping to alleviate bradycardia. Questran is a medication used to lower cholesterol levels and is not indicated for bradycardia. Digitalis, such as Digoxin, is used for heart failure and atrial fibrillation but not typically for bradycardia. Nitroglycerin is primarily used for angina and not bradycardia.

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