Nursing Elites

1. What action should the nurse take for a patient admitted with diabetic ketoacidosis exhibiting rapid, deep respirations?

• A. Administer the prescribed PRN lorazepam (Ativan).
• B. Start the prescribed PRN oxygen at 2 to 4 L/min.
• C. Administer the prescribed normal saline bolus and insulin.
• D. Encourage the patient to practice guided imagery for relaxation.

Correct answer: C

Rationale: The correct action for a patient with diabetic ketoacidosis and rapid, deep (Kussmaul) respirations is to administer a normal saline bolus and insulin. The rapid, deep respirations indicate a metabolic acidosis, which requires correction with a saline bolus to prevent hypovolemia and insulin to facilitate glucose re-entry into cells. Oxygen therapy is not necessary since the increased respiratory rate is compensatory and not due to hypoxemia. Encouraging relaxation techniques or administering lorazepam are inappropriate as they can worsen the acidosis by suppressing the compensatory respiratory effort.

2. What nursing intervention can help alleviate pruritus in a client with cirrhosis?

• A. Administering antihistamines
• B. Providing a high-protein diet
• C. Applying emollients to the skin
• D. Encouraging frequent baths with hot water

Correct answer: C

Rationale: Applying emollients to the skin can help alleviate pruritus in clients with cirrhosis. Emollients help soothe and moisturize the skin, reducing the discomfort associated with itching.

3. A 35-year-old man presents with fatigue, weight loss, and hyperpigmentation of the skin. Laboratory tests reveal hyponatremia, hyperkalemia, and low cortisol levels. What is the most likely diagnosis?

• A. Cushing's syndrome
• B. Addison's disease
• C. Hypothyroidism
• D. Pheochromocytoma

Correct answer: B

Rationale: The clinical presentation of a 35-year-old man with fatigue, weight loss, hyperpigmentation of the skin, hyponatremia, hyperkalemia, and low cortisol levels is classic for Addison's disease. These findings are consistent with primary adrenal insufficiency, where the adrenal glands fail to produce adequate cortisol. In Addison's disease, the adrenal cortex is damaged, leading to decreased cortisol production and elevated levels of ACTH. This results in symptoms such as fatigue, weight loss, and hyperpigmentation due to increased ACTH production stimulating melanocytes. Hyponatremia and hyperkalemia are common electrolyte abnormalities seen in Addison's disease due to aldosterone deficiency. Therefore, the correct diagnosis in this case is Addison's disease.

4. A client with chronic renal failure is prescribed epoetin alfa (Epogen). Which outcome indicates that the medication is effective?

• A. Increased urine output.
• B. Decreased blood pressure.
• C. Improved hemoglobin levels.
• D. Stable potassium levels.

Correct answer: C

Rationale: Epoetin alfa is a medication that stimulates red blood cell production. Therefore, in a client with chronic renal failure, an effective outcome of epoetin alfa therapy would be an improvement in hemoglobin levels. This indicates that the medication is working as intended by addressing anemia, a common complication of chronic renal failure. Increased urine output (choice A) is not directly related to the action of epoetin alfa. Decreased blood pressure (choice B) is not a primary expected outcome of epoetin alfa therapy. Stable potassium levels (choice D) are important but not a direct indicator of the effectiveness of epoetin alfa in this context.

5. A client with a history of myocardial infarction (MI) is prescribed atorvastatin (Lipitor). Which outcome indicates that the medication is effective?

• A. Increased blood pressure.
• B. Lowered cholesterol levels.
• C. Decreased heart rate.
• D. Improved liver function.

Correct answer: B

Rationale: The correct answer is B: Lowered cholesterol levels. Atorvastatin is a medication commonly prescribed to lower cholesterol levels, which is crucial in reducing the risk of further cardiovascular events, including myocardial infarction (MI). Monitoring cholesterol levels is essential to assess the effectiveness of atorvastatin therapy and its role in preventing future cardiac complications. Choices A, C, and D are incorrect because increased blood pressure, decreased heart rate, and improved liver function are not direct indicators of atorvastatin's effectiveness in a client with a history of MI.

Similar Questions