Nursing Elites

1. What dietary recommendations should be given to a patient with pre-dialysis end-stage kidney disease?

• A. Reduce phosphorus intake to 700 mg/day
• B. Increase sodium intake
• C. Increase protein intake
• D. Increase potassium intake

Correct answer: A

Rationale: The correct recommendation for a patient with pre-dialysis end-stage kidney disease is to reduce phosphorus intake to 700 mg/day. High phosphorus levels can lead to complications in such patients. Increasing sodium intake (Choice B) is generally not recommended due to its association with hypertension and fluid retention. While protein is essential, increasing protein intake (Choice C) in kidney disease can be harmful as it can lead to increased waste products that the kidneys may struggle to excrete. Increasing potassium intake (Choice D) is not advisable as well, as patients with kidney disease may already have difficulty excreting potassium, leading to hyperkalemia.

2. What ECG changes should be monitored in a patient with hypokalemia?

• A. Flattened T waves and prominent U waves
• B. Elevated ST segments and wide QRS complexes
• C. Tall T waves and flattened QRS complexes
• D. Widened QRS complexes and decreased P wave amplitude

Correct answer: A

Rationale: The correct answer is A: Flattened T waves and prominent U waves. In hypokalemia, there is a decrease in potassium levels, which can lead to ECG changes such as flattened T waves and prominent U waves. These changes are classic findings associated with hypokalemia. Choices B (Elevated ST segments and wide QRS complexes), C (Tall T waves and flattened QRS complexes), and D (Widened QRS complexes and decreased P wave amplitude) are all incorrect. Elevated ST segments and wide QRS complexes are not typically seen in hypokalemia. Tall T waves and flattened QRS complexes, as well as widened QRS complexes and decreased P wave amplitude, do not represent the typical ECG changes seen in hypokalemia.

3. A nurse is caring for a client who has a traumatic brain injury. Which of the following findings should indicate to the nurse the need for immediate intervention?

• A. Axillary temperature 37.2°C (99°F)
• B. Apical pulse 100/min
• C. Respiratory rate 30/min
• D. Blood pressure 140/84 mm Hg

Correct answer: C

Rationale: The correct answer is C. The nurse should prioritize airway and breathing in a client with a traumatic brain injury. An increased respiratory rate may indicate CO2 retention, which could lead to increased intracranial pressure. Choice A, axillary temperature 37.2°C (99°F), is within normal range and does not indicate an immediate need for intervention. Choice B, apical pulse 100/min, is slightly elevated but not as critical as respiratory distress in this scenario. Choice D, blood pressure 140/84 mm Hg, is also within normal limits and does not require immediate intervention compared to the respiratory rate.

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

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

Correct answer: A

Rationale: Continuous bubbling in the water seal chamber of a chest tube indicates an air leak. This bubbling occurs when air leaks from the patient's pleural space into the chest tube system. It is essential to address this issue promptly to prevent complications like a pneumothorax. Choices B, C, and D are incorrect because continuous bubbling in the water seal chamber is not indicative of normal chest tube function, a blockage in the chest tube, or a malfunction in the drainage system.

5. When caring for a patient with hypokalemia, what should the nurse monitor for?

• A. Monitor for muscle weakness
• B. Check for cardiac dysrhythmias
• C. Monitor for bradycardia
• D. Monitor for seizures

Correct answer: A

Rationale: Corrected Answer: Muscle weakness is a common sign of hypokalemia. The nurse should monitor for muscle weakness as potassium plays a crucial role in muscle function. Choices B, C, and D are incorrect because although hypokalemia can lead to cardiac dysrhythmias, bradycardia, and even seizures in severe cases, muscle weakness is a more common and specific sign directly related to potassium levels.

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