Nursing Elites

1. What are the dietary recommendations for a patient with GERD?

• A. Avoid mint and spicy foods
• B. Eat large meals before bedtime
• C. Consume liquids with meals
• D. Avoid NSAIDs

Correct answer: A

Rationale: The correct answer is to avoid mint and spicy foods for a patient with GERD. These foods can increase gastric acid secretion and worsen symptoms of GERD. Choice B is incorrect because eating large meals before bedtime can exacerbate GERD symptoms due to increased gastric pressure when lying down. Choice C is also incorrect as consuming liquids with meals can lead to increased gastric distention, potentially triggering GERD symptoms. Choice D, avoiding NSAIDs, though important for some patients with GERD due to their potential to irritate the stomach lining, is not a general dietary recommendation for all GERD patients.

2. A patient with a chest tube has continuous bubbling in the water seal chamber. What does this indicate?

• A. An air leak
• B. A blocked chest tube
• C. Drainage from the site
• D. Blood clot in the chest tube

Correct answer: A

Rationale: Continuous bubbling in the water seal chamber of a chest tube indicates an air leak. This situation requires immediate attention to prevent complications such as lung collapse. A blocked chest tube would typically result in absent or fluctuating bubbling. Drainage from the site would be observed in the collection chamber, not the water seal chamber. A blood clot in the chest tube would lead to cessation of drainage.

3. What are the expected findings in a patient with hypokalemia?

• A. Cardiac dysrhythmias
• B. Seizures and confusion
• C. Bradycardia
• D. Muscle weakness

Correct answer: A

Rationale: The correct answer is A: Cardiac dysrhythmias. Hypokalemia is commonly associated with cardiac dysrhythmias due to the role potassium plays in maintaining proper electrical conduction in the heart. Choices B, C, and D are incorrect. While hypokalemia can lead to muscle weakness, the most critical and life-threatening manifestation is cardiac dysrhythmias. Seizures and confusion are more commonly associated with other electrolyte imbalances, such as hyponatremia. Bradycardia is not a typical finding in hypokalemia, as it tends to cause tachycardia or other arrhythmias.

4. What is the first nursing action for a patient with chest pain and possible acute coronary syndrome?

• A. Administer sublingual nitroglycerin
• B. Increase fluids to prevent dehydration
• C. Obtain cardiac enzymes
• D. Get IV access and auscultate heart sounds

Correct answer: A

Rationale: Administering sublingual nitroglycerin is the priority nursing action for a patient with chest pain and possible acute coronary syndrome. Nitroglycerin helps dilate the blood vessels, improve blood flow to the heart, and reduce cardiac workload. This action aims to relieve chest pain promptly and prevent further cardiac tissue damage. Increasing fluids is not the initial priority for a patient with chest pain and possible acute coronary syndrome. Obtaining cardiac enzymes is important for diagnosis but is not the first action in managing acute symptoms. Getting IV access and auscultating heart sounds are important interventions, but they come after administering sublingual nitroglycerin in the management of acute coronary syndrome.

5. What lab value should be monitored in a patient with HIV?

• A. CD4 T-cell count below 180 cells/mm3
• B. Serum albumin levels
• C. Hemoglobin levels
• D. White blood cell count

Correct answer: A

Rationale: The correct answer is A: CD4 T-cell count below 180 cells/mm3. Monitoring the CD4 T-cell count is crucial in patients with HIV as it indicates the level of immunocompromise. A CD4 T-cell count below 180 cells/mm3 signifies severe immunosuppression and an increased risk of opportunistic infections. Serum albumin levels (choice B) are important for nutritional status assessment but not specific to HIV monitoring. Hemoglobin levels (choice C) are important for assessing anemia but do not directly reflect HIV disease progression. White blood cell count (choice D) is a general marker of inflammation and infection, but monitoring CD4 T-cell count is more specific and crucial in managing HIV.

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