Nursing Elites

1. 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.

2. What is the initial nursing action for a patient with chest pain and acute coronary syndrome?

• A. Administer sublingual nitroglycerin
• B. Check the patient's urine output
• C. Check cardiac enzymes
• D. Obtain IV access

Correct answer: A

Rationale: Administering sublingual nitroglycerin is the priority initial action for a patient with chest pain and acute coronary syndrome. Nitroglycerin helps vasodilate coronary arteries, improving blood flow to the heart muscle and reducing chest pain. Checking the patient's urine output (choice B) and cardiac enzymes (choice C) are important assessments but are not the first priority when managing acute chest pain. Obtaining IV access (choice D) is essential for administering medications and fluids, but administering sublingual nitroglycerin takes precedence in the initial management of chest pain in acute coronary syndrome.

3. What dietary recommendations should be given to a patient with GERD?

• A. Avoid mint and spicy foods
• B. Eat large meals before bed
• C. Increase fluid intake during meals
• D. Drink milk as a snack

Correct answer: A

Rationale: The correct dietary recommendation for a patient with GERD is to avoid mint and spicy foods. These foods can trigger symptoms of GERD and lead to acid reflux. Choice B is incorrect because eating large meals before bed can exacerbate GERD symptoms by increasing the likelihood of acid reflux during sleep. Choice C is incorrect as increasing fluid intake during meals can worsen GERD symptoms by distending the stomach, leading to increased pressure on the lower esophageal sphincter. Choice D is also incorrect because while milk may provide temporary relief for some individuals, it is not a recommended long-term solution for managing GERD.

4. A nurse is administering insulin to a patient after misreading their glucose as 210 mg/dL instead of 120 mg/dL. What should the nurse monitor for?

• A. Monitor for hypoglycemia
• B. Monitor for hyperkalemia
• C. Administer glucose IV
• D. Document the incident

Correct answer: A

Rationale: The correct answer is to monitor for hypoglycemia. Insulin administration based on a misread glucose level can lead to hypoglycemia due to the unnecessary lowering of blood sugar levels. Monitoring for hypoglycemia involves assessing the patient's blood glucose levels frequently, observing for signs and symptoms such as shakiness, confusion, sweating, and administering glucose if hypoglycemia occurs. Choice B, monitoring for hyperkalemia, is incorrect as insulin administration typically lowers potassium levels. Choice C, administering glucose IV, is not the immediate action needed as the patient could potentially develop hypoglycemia from the excess insulin. Choice D, documenting the incident, is important but not the immediate priority when dealing with a potential hypoglycemic event.

5. A client scheduled for electromyography (EMG) will have small needle electrodes inserted into the muscles. What should the nurse include in the teaching?

• A. You will receive a fixed dose of radioisotope 2 hours before the procedure.
• B. Momentary flushing will occur at the beginning of the procedure.
• C. You should inform your provider if you are claustrophobic.
• D. You should expect insertion of small needle electrodes into the muscles.

Correct answer: D

Rationale: The correct answer is D. During an electromyography (EMG) procedure, small needle electrodes are inserted into the muscles to assess muscle weakness and nerve responses. Choices A, B, and C are incorrect because radioisotope is not used in EMG, flushing is not a typical occurrence, and claustrophobia is more relevant for imaging procedures like MRI or CT scans, not EMG.

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