Nursing Elites

1. Fat-soluble vitamins are different from water-soluble vitamins because the body is able to store only small amounts of fat-soluble vitamins.

• A. Both the statement and the reason are correct and related.
• B. Both the statement and the reason are correct but are not related.
• C. The statement is correct, but the reason is not correct.
• D. The statement is not correct, but the reason is correct.

Correct answer: C

Rationale: The statement is correct, but the reason is not correct. A major difference between fat-soluble and water-soluble vitamins is that the body is able to store larger amounts of fat-soluble vitamins. Vitamins A and D are stored for long periods; therefore, minor shortages might not be identified until drastic depletion has occurred. Observable signs and symptoms of a dietary deficiency are often not identified until they are in an advanced state. Water-soluble vitamins, on the other hand, are not stored in the body and are excreted in the urine if taken in excess, making it harder to reach toxic levels.

2. A client receiving total parenteral nutrition (TPN) suddenly develops tremors, dizziness, and diaphoresis. The client said, 'I feel weak and the bag was empty.' Which is the most likely complication the client is currently experiencing?

• A. Fluid volume overload
• B. Sepsis
• C. Hyperglycemia
• D. Hypoglycemia

Correct answer: D

Rationale: The client experiencing tremors, dizziness, diaphoresis, weakness, and stating that the TPN bag is empty is likely experiencing hypoglycemia. Hypoglycemia can occur when the TPN infusion suddenly stops, leading to a rapid drop in blood sugar levels. Symptoms of hypoglycemia include tremors, dizziness, diaphoresis, and weakness. Choices A, B, and C are incorrect as the symptoms presented are more consistent with hypoglycemia rather than fluid volume overload, sepsis, or hyperglycemia.

3. In some hip surgeries, an epidural catheter for Fentanyl epidural analgesia is given. What is your nursing priority care in such a case?

• A. Instruct the client to observe strict bed rest
• B. Check for epidural catheter drainage
• C. Administer analgesia through the epidural catheter as prescribed
• D. Assess respiratory rate carefully

Correct answer: D

Rationale: The nursing priority care in a case where an epidural catheter for Fentanyl epidural analgesia is given during hip surgeries is to assess the respiratory rate carefully. Respiratory depression is a potential side effect of Fentanyl, especially when administered epidurally. Monitoring the respiratory rate is crucial to detect any signs of respiratory distress promptly. Instructing the client to observe strict bed rest (Choice A) may be necessary but is not the priority over ensuring respiratory function. Checking for epidural catheter drainage (Choice B) and administering analgesia through the epidural catheter as prescribed (Choice C) are important aspects of care, but ensuring adequate ventilation takes precedence to prevent complications.

4. What type of drug is lamivudine, used for the management of HIV infection?

• A. CCR5 antagonist
• B. fusion inhibitor
• C. nucleoside reverse transcriptase inhibitor
• D. protease inhibitor

Correct answer: C

Rationale: Lamivudine belongs to the class of nucleoside reverse transcriptase inhibitors (NRTIs), making choice C the correct answer. NRTIs like lamivudine work by inhibiting the reverse transcriptase enzyme, an essential component for the HIV virus to replicate. Choices A, B, and D are incorrect because lamivudine does not function as a CCR5 antagonist, fusion inhibitor, or protease inhibitor in the management of HIV infection.

5. Which factor contributes to the development of bone diseases in patients with Chronic Kidney Disease (CKD) due to retention?

• A. Iron
• B. Sodium
• C. Potassium
• D. Phosphorus

Correct answer: D

Rationale: The correct answer is phosphorus. Retention of phosphorus in patients with Chronic Kidney Disease (CKD) contributes to the development of bone disorders, including osteodystrophy, because it disrupts the balance of calcium and phosphorus in the body. This imbalance leads to a variety of bone diseases. The other options - iron, sodium, and potassium - while important in the overall metabolic function, are not directly linked to the development of bone diseases in CKD patients due to retention.

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