Nursing Elites

1. How does hyponatremia place the patient at risk?

• A. Seizures
• B. Fatigue
• C. Cardiac dysrhythmias
• D. Muscle weakness

Correct answer: C

Rationale: Hyponatremia places the patient at risk for cardiac dysrhythmias. While hyponatremia can lead to seizures due to cerebral edema caused by fluid imbalance, the most immediate and life-threatening risk is cardiac dysrhythmias. Low sodium levels can disrupt the heart's electrical activity, potentially leading to fatal arrhythmias. Although fatigue and muscle weakness are symptoms of hyponatremia, cardiac dysrhythmias pose the most critical concern as they can have severe consequences.

2. What does continuous bubbling in the water seal chamber of a chest tube indicate?

• A. An air leak
• B. A blockage in the chest tube
• C. Normal chest tube function
• D. Malfunction in the drainage system

Correct answer: A

Rationale: Continuous bubbling in the water seal chamber indicates an air leak in the chest tube system. This bubbling occurs when air is escaping through the tube and entering the water seal chamber. Choice B, a blockage in the chest tube, is incorrect as continuous bubbling does not suggest a blockage. Choice C, normal chest tube function, is incorrect because continuous bubbling is not an expected finding in a properly functioning chest tube. Choice D, a malfunction in the drainage system, is incorrect as continuous bubbling specifically points towards an air leak, not a general malfunction.

3. What is an escharotomy and why is it performed?

• A. A surgical incision made to improve circulation in burn injuries
• B. A procedure to remove dead tissue from a wound
• C. A procedure to remove excess fluid from the lungs
• D. A procedure to relieve pain from burns

Correct answer: A

Rationale: An escharotomy is a surgical procedure involving an incision through the eschar (dead tissue) to relieve pressure in burn injuries. It is performed to improve circulation to the affected area, prevent further damage, and restore blood flow. Choice B is incorrect because an escharotomy is not primarily focused on removing dead tissue but rather on relieving pressure. Choice C is incorrect as it describes a procedure related to pulmonary issues, not burn injuries. Choice D is incorrect because while pain relief may be a result of an escharotomy, it is not the primary purpose of the procedure.

4. What are the expected manifestations of a thrombotic stroke?

• A. Gradual loss of function on one side of the body
• B. Loss of sensation in the affected extremity
• C. Sudden loss of consciousness
• D. Seizures and convulsions

Correct answer: A

Rationale: The correct answer is A: Gradual loss of function on one side of the body. Thrombotic strokes are caused by a clot forming in a blood vessel supplying the brain, leading to a gradual onset of symptoms due to impaired blood flow to specific brain regions. Choices B, C, and D are incorrect because loss of sensation, sudden loss of consciousness, seizures, and convulsions are not typically associated with thrombotic strokes. In a thrombotic stroke, the symptoms develop slowly over time, often over minutes to hours, and include manifestations such as weakness, numbness, or paralysis on one side of the body, along with other symptoms related to the affected brain area.

5. A nurse is caring for a client with rheumatoid arthritis who has been taking prednisone. Which of the following findings should the nurse identify as an adverse effect of this medication?

• A. Weight loss
• B. Hypoglycemia
• C. Hypertension
• D. Hyperkalemia

Correct answer: C

Rationale: The correct answer is C, 'Hypertension.' Prednisone, a corticosteroid, can lead to hypertension as an adverse effect. Prednisone can cause sodium retention and potassium loss, leading to increased blood pressure. Weight loss (choice A) is not a common adverse effect of prednisone; in fact, weight gain is more common. Hypoglycemia (choice B) is not typically associated with prednisone use; instead, hyperglycemia is a common concern. Hyperkalemia (choice D) is also unlikely with prednisone use; instead, hypokalemia is a potential electrolyte imbalance.

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