Nursing Elites

1. What ECG changes are seen with hyperkalemia?

• A. Flattened T waves
• B. Elevated ST segments
• C. Prominent U waves
• D. Widened QRS complex

Correct answer: A

Rationale: Flattened T waves are an early ECG sign of hyperkalemia. Hyperkalemia affects the repolarization phase of the cardiac action potential, leading to changes such as peaked T waves, prolonged PR interval, widened QRS complex, and ultimately sine wave pattern. Elevated ST segments, prominent U waves, and widened QRS complex are not typically associated with hyperkalemia, making choices B, C, and D incorrect.

2. A patient with GERD is receiving dietary teaching from a nurse. What should the nurse recommend?

• A. Avoid mint and pepper
• B. Increase fluid intake before meals
• C. Eat three large meals per day
• D. Avoid drinking water with meals

Correct answer: A

Rationale: The correct recommendation for a patient with GERD is to avoid foods like mint and pepper, as these can help reduce gastric acid secretion and alleviate symptoms. Mint and pepper are known to relax the lower esophageal sphincter, leading to increased reflux. Increasing fluid intake before meals (choice B) may worsen GERD symptoms by distending the stomach. Eating three large meals per day (choice C) can also aggravate GERD because large meals can lead to increased gastric pressure and reflux. Avoiding drinking water with meals (choice D) is generally recommended for GERD; however, the most crucial advice in this case is to avoid mint and pepper for better symptom management.

3. A client who has burn injuries covering their upper body is concerned about their altered appearance. Which of the following statements should the nurse make?

• A. It is okay to not want to touch the burned areas of your body.
• B. Cosmetic surgery should be performed within the next year to be effective.
• C. Reconstructive surgery can completely restore your previous appearance.
• D. It could be helpful for you to attend a support group for people who have burn injuries.

Correct answer: D

Rationale: The nurse should encourage the client to attend a support group for individuals who have burn injuries. Support groups can provide emotional support, shared experiences, and coping strategies for accepting their altered appearance. Choice A is not the best response as it does not offer proactive support. Choice B is not appropriate as the timing of cosmetic surgery should be determined by healthcare providers, not immediate. Choice C is misleading as reconstructive surgery may improve appearance but may not completely restore the previous look.

4. A patient with hypokalemia is being monitored. What should the nurse assess for?

• A. Muscle weakness
• B. Flattened T waves
• C. Checking deep tendon reflexes
• D. Seizures

Correct answer: A

Rationale: Corrected Question: A patient with hypokalemia is being monitored. What should the nurse assess for? Corrected Choice A: Muscle weakness Corrected Choice B: Flattened T waves Corrected Choice C: Checking deep tendon reflexes Corrected Choice D: Seizures Rationale: Hypokalemia is associated with muscle weakness due to the effect of low potassium levels on muscle function. Flattened T waves on an ECG are characteristic of hypokalemia but are not a direct assessment for the patient's condition. Checking deep tendon reflexes and seizures are not primary symptoms associated with hypokalemia, making them less relevant for monitoring a patient with this electrolyte imbalance.

5. A nurse is providing discharge teaching to a client following a heart transplant. Which of the following information should the nurse include in the teaching?

• A. Immunosuppressant medications need to be taken for up to 1 year
• B. Shortness of breath might be an indication of transplant rejection
• C. The surgical site will heal in 3 to 4 weeks after surgery
• D. Begin 45 minutes of moderate aerobic exercise per day following discharge

Correct answer: B

Rationale: The correct answer is B. Shortness of breath is an important sign of transplant rejection. Other manifestations of rejection include fatigue, edema, bradycardia, and hypotension. Choices A, C, and D are incorrect because: A) Immunosuppressant medications are typically required for life, not just up to 1 year. C) The surgical site healing time can vary and may take longer than 3 to 4 weeks. D) Starting a specific exercise regimen should be individualized and guided by healthcare providers; a general recommendation like 45 minutes of exercise per day may not be suitable for all heart transplant recipients.

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