Nursing Elites

1. What are the expected signs of compartment syndrome?

• A. Unrelieved pain, pallor, and pulselessness
• B. Fever, swelling, and redness
• C. Muscle cramps and weakness
• D. Redness and itching

Correct answer: A

Rationale: The correct answer is A: Unrelieved pain, pallor, and pulselessness. Compartment syndrome is characterized by increased pressure within a muscle compartment, leading to inadequate blood supply. This results in severe pain that is unrelieved by rest or medication, pallor due to compromised blood flow, and pulselessness as a late sign of severe ischemia. Choices B, C, and D are incorrect. Fever, swelling, and redness are not typical signs of compartment syndrome. Muscle cramps and weakness may occur due to other conditions, but they are not primary indicators of compartment syndrome. Redness and itching are also not commonly associated with compartment syndrome.

2. Which ECG change is associated with hyperkalemia?

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

Correct answer: A

Rationale: Flattened T waves are a characteristic ECG change seen in hyperkalemia. Hyperkalemia affects the repolarization phase of the cardiac cycle, leading to T wave abnormalities. Prominent U waves are typically seen in hypokalemia. Elevated ST segments are more indicative of myocardial infarction or pericarditis. Widened QRS complexes are commonly associated with conditions like bundle branch blocks or certain toxicities.

3. A nurse is caring for a client who is hyperventilating and has the following ABG results: pH 7.50, PaCO2 29 mm Hg, and HCO3- 25 mEq/L. The nurse should recognize that the client has which of the following acid-base imbalances?

• A. Respiratory acidosis
• B. Respiratory alkalosis
• C. Metabolic acidosis
• D. Metabolic alkalosis

Correct answer: B

Rationale: The correct answer is B: Respiratory alkalosis. In this scenario, the client is experiencing respiratory alkalosis due to hyperventilation. Hyperventilation leads to excessive loss of carbon dioxide, causing a decrease in hydrogen ion concentration and an increase in pH levels. Choices A, C, and D are incorrect. Respiratory acidosis is characterized by high PaCO2 and low pH. Metabolic acidosis is associated with low HCO3- levels and low pH. Metabolic alkalosis is marked by high HCO3- levels and high pH. In this case, the ABG results indicate respiratory alkalosis.

4. A nurse is providing teaching to a client who was newly diagnosed with nephrotic syndrome. Which of the following statements should indicate to the nurse that the client understands the teaching?

• A. I can expect swelling in my hands and on my face.
• B. The amount of protein in my blood is high.
• C. I might have some pain and gas in my stomach from this condition.
• D. I will use a soft bristle toothbrush to prevent bleeding gums.

Correct answer: A

Rationale: The correct answer is A. Nephrotic syndrome leads to edema, especially of the face and dependent areas, due to the loss of protein in the urine. Choice B is incorrect because nephrotic syndrome leads to protein loss in the urine, not an increase in blood protein levels. Choice C is incorrect as stomach pain and gas are not typical symptoms of nephrotic syndrome. Choice D is incorrect as using a soft bristle toothbrush is not directly related to the manifestations of nephrotic syndrome.

5. What should a healthcare professional do if a patient experiences abdominal cramping during enema administration?

• A. Lower the height of the enema solution container
• B. Stop the procedure and remove the tubing
• C. Continue the enema at a slower rate
• D. Increase the flow of the enema solution

Correct answer: A

Rationale: When a patient experiences abdominal cramping during enema administration, the healthcare professional should lower the height of the enema solution container. This action helps relieve the cramping by slowing down the flow of the enema solution, making it more comfortable for the patient. Stopping the procedure and removing the tubing (Choice B) may be necessary in some cases, but it should not be the first step when cramping occurs. Continuing the enema at a slower rate (Choice C) may exacerbate the cramping, so it is not the best course of action. Increasing the flow of the enema solution (Choice D) will likely worsen the cramping and should be avoided.

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