Nursing Elites

1. A nurse reviews a client's laboratory report and notes that the client's serum phosphorus level is 2.0 mg/dL. Which condition most likely caused this serum phosphorus level?

• A. Alcoholism
• B. Renal insufficiency
• C. Hypoparathyroidism
• D. Tumor lysis syndrome

Correct answer: A

Rationale: The correct answer is A: Alcoholism. Alcoholism can lead to hypophosphatemia due to poor dietary intake and other factors. Excessive alcohol consumption can result in malnutrition, particularly a deficiency in phosphorus. Choices B, C, and D are unlikely to cause low serum phosphorus levels. Renal insufficiency is more likely to cause hyperphosphatemia, hypoparathyroidism is associated with hypocalcemia rather than hypophosphatemia, and tumor lysis syndrome typically presents with hyperphosphatemia due to the release of intracellular phosphate.

2. Based on the signs and symptoms of erythema marginatum, Sydenham chorea, epistaxis, abdominal pain, fever, cardiac problems, and skin nodules in your 32-year-old female patient, what disorder would you most likely suspect?

• A. Leukemia
• B. Histoplasmosis
• C. Pneumocystis jiroveci
• D. Rheumatoid arthritis

Correct answer: D

Rationale: The signs and symptoms described point towards rheumatoid arthritis. Erythema marginatum, Sydenham chorea, epistaxis, abdominal pain, fever, cardiac issues, and skin nodules are classic manifestations of rheumatic fever, which is a complication of untreated streptococcal infection. This condition can lead to rheumatoid arthritis over time. Choices A, B, and C are incorrect as they do not align with the provided signs and symptoms, and they are not associated with the clinical presentation described.

3. What is an episiotomy?

• A. A surgical incision of the perineum to prevent tearing during delivery.
• B. Releasing the red plug from the cervix just before crowning occurs.
• C. An incision in the abdomen with which the baby can be delivered through.
• D. The severance of the umbilical cord between mother and child.

Correct answer: A

Rationale: An episiotomy is a surgical incision of the perineum to prevent tearing during delivery. This procedure is performed to widen the vaginal opening and facilitate childbirth. Choice B is incorrect as it describes the expulsion of the mucus plug, not an episiotomy. Choice C is incorrect as it refers to a different procedure, a cesarean section, where the baby is delivered through an incision in the abdomen. Choice D is incorrect as it pertains to cutting the umbilical cord, which is not related to an episiotomy.

4. Your patient has a blood potassium level of 9.2 mEq/L. What intervention should you anticipate for this patient?

• A. Intravenous potassium supplementation
• B. Intravenous calcium supplementation
• C. Kidney dialysis
• D. Parenteral nutrition

Correct answer: C

Rationale: The correct answer is C: Kidney dialysis. A blood potassium level of 9.2 mEq/L indicates severe hyperkalemia, which can be life-threatening. Kidney dialysis is the most appropriate intervention to rapidly lower potassium levels in this situation. Choice A, intravenous potassium supplementation, would worsen the hyperkalemia. Choice B, intravenous calcium supplementation, is not the primary intervention for hyperkalemia. Choice D, parenteral nutrition, is unrelated to treating hyperkalemia and would not address the immediate concern.

5. You are caring for a neonate who has a cleft palate. You should inform the mother that surgical correction will be done when the infant is:

• A. 8 to 12 months of age.
• B. 20 to 24 months of age.
• C. 16 to 20 months of age.
• D. 12 to 16 months of age.

Correct answer: A

Rationale: The correct answer is A: 8 to 12 months of age. Surgical correction for a cleft palate is typically performed around this age to optimize speech development and prevent feeding difficulties. Options B, C, and D suggest later ages for surgery, which may lead to speech and feeding issues due to the delay in correction.

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