Nursing Elites

1. Following cardiothoracic surgery where controlled therapeutic hypothermia was utilized to decrease metabolic demands, the nurse responsible for monitoring this client postoperatively should be assessing for which potential complication related to cold cardioplegia?

• A. Thrombocytopenia
• B. Hypokalemia
• C. Hyperglycemia
• D. Coagulopathy

Correct answer: D

Rationale: Coagulopathy is the correct answer. During therapeutic hypothermia, which lowers the body's temperature to reduce metabolic demands post-surgery, coagulopathy, or impaired blood clotting, is a potential complication due to the effects of cold cardioplegia. Thrombocytopenia (choice A) refers to a low platelet count and is not directly related to cold cardioplegia. Hypokalemia (choice B) is a condition of low potassium levels, and hyperglycemia (choice C) is high blood sugar levels, neither of which are primary complications of cold cardioplegia.

2. Which of the following hormones helps to raise the blood sugar level to help maintain homeostasis?

• A. Antidiuretic hormone (ADH)
• B. Insulin
• C. Glucagon
• D. Thyroxine

Correct answer: C

Rationale: The correct answer is C, Glucagon. Glucagon helps raise blood sugar levels by stimulating the liver to release stored glucose into the bloodstream, thus aiding in maintaining homeostasis. Antidiuretic hormone (ADH), choice A, functions in regulating water balance in the body, not blood sugar levels. Insulin, choice B, lowers blood sugar levels by facilitating glucose uptake by cells. Thyroxine, choice D, is a hormone produced by the thyroid gland that regulates metabolism and has no direct effect on blood sugar levels.

3. A male patient is being treated with testosterone gel for hypogonadism. What important instruction should the nurse provide?

• A. Apply the gel to the face and neck for maximum absorption.
• B. Apply the gel to the chest or upper arms and allow it to dry completely before dressing.
• C. Apply the gel to the scalp and back.
• D. Apply the gel to the genitals for improved results.

Correct answer: B

Rationale: The correct instruction for applying testosterone gel is to apply it to the chest or upper arms and allow it to dry completely before dressing. This is important to prevent the transfer of the medication to others. Applying it to the face and neck (Choice A) is incorrect as these areas are not recommended. Similarly, applying it to the scalp and back (Choice C) or the genitals (Choice D) is also incorrect and can lead to inappropriate absorption or undesirable effects.

4. The nurse is preparing to administer a vaccine to a newborn. Before administering the vaccine, the nurse should

• A. warm the vaccine to room temperature.
• B. gently cleanse the chosen injection site.
• C. check the infant's temperature.
• D. administer the full dose at a single injection site.

Correct answer: C

Rationale: Before administering a vaccine to a newborn, it is essential for the nurse to check the infant's temperature. This is important to ensure that the newborn does not have a fever, which could indicate an underlying infection or illness. Warming the vaccine to room temperature is not necessary and could be harmful. Vigorously massaging the injection site is not recommended as it can cause discomfort and tissue damage. Dividing the dose for administration to three injection sites is not standard practice for vaccine administration to a newborn.

5. In nephritic syndrome compared to nephrotic syndrome, there is:

• A. higher amounts of albuminuria.
• B. negligible hematuria or absence of hematuria.
• C. presence of red blood cell casts in the urine.
• D. hypoalbuminemia

Correct answer: C

Rationale: In nephritic syndrome, the presence of red blood cell casts in the urine is a characteristic finding, reflecting glomerular inflammation and damage. This differentiates it from nephrotic syndrome, where red blood cell casts are typically absent. Choice A is incorrect because nephritic syndrome usually presents with less albuminuria compared to nephrotic syndrome. Choice B is incorrect as hematuria is a common feature of nephritic syndrome. Choice D is incorrect as hypoalbuminemia is more commonly associated with nephrotic syndrome.

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