Nursing Elites

1. What is the appropriate electrical intervention for a patient with ventricular tachycardia and a pulse?

• A. Defibrillation
• B. Synchronized cardioversion
• C. Pacing
• D. Medication administration

Correct answer: B

Rationale: Synchronized cardioversion is the correct electrical intervention for a patient with ventricular tachycardia and a pulse. This procedure delivers a synchronized electrical shock to the heart during a specific phase of the cardiac cycle, aiming to restore the heart's normal rhythm. Defibrillation (choice A) is used for pulseless ventricular tachycardia or ventricular fibrillation. Pacing (choice C) is typically used for bradycardias or certain types of heart blocks. Medication administration (choice D) may be used in some cases, but in the scenario of ventricular tachycardia with a pulse, synchronized cardioversion is the preferred intervention.

2. A nurse is teaching a client who has type 1 DM about hypoglycemia. Which of the following statements by the client indicates an understanding of the teaching?

• A. Exercise reduces the risk for hypoglycemia.
• B. I can skip my insulin when I don't eat.
• C. I can drink 4 oz of soda if my blood sugar is low.
• D. Diabetic pills don't cause hypoglycemia; only insulin does.

Correct answer: C

Rationale: The client can correct any development of hypoglycemia with a quick intake of glucose. The client should have 15 g carbohydrates on hand to treat hypoglycemic episodes, like 4 oz of regular soda.

3. Which lab value is a priority for a patient with HIV?

• A. CD4 T-cell count 180 cells/mm3
• B. Albumin levels below 3.5 g/dL
• C. Potassium levels below 3.5 mEq/L
• D. White blood cell count below 5000/mm3

Correct answer: A

Rationale: A CD4 T-cell count of less than 180 cells/mm3 is a priority for a patient with HIV because it indicates severe immunocompromise and an increased risk for opportunistic infections. Monitoring CD4 levels helps in assessing the immune status and guiding treatment decisions in patients with HIV. Albumin levels (choice B) are important for assessing nutritional status but are not a direct indicator of immune function in HIV patients. Potassium levels (choice C) and white blood cell count (choice D) are also important, but the CD4 T-cell count is specifically crucial for evaluating the immune function in individuals with HIV.

4. What intervention is needed for a patient with a chest tube and an air leak?

• A. Tighten the connections of the chest tube system
• B. Replace the chest tube
• C. Clamp the chest tube
• D. Continue to monitor the chest tube

Correct answer: A

Rationale: The correct intervention for a patient with a chest tube and an air leak is to tighten the connections of the chest tube system. This step helps prevent air leaks and ensures the proper functioning of the chest tube. Choice B, replacing the chest tube, is not necessary as tightening the connections should be attempted first. Clamping the chest tube (Choice C) is not recommended as it can lead to complications by obstructing the drainage system. Continuing to monitor the chest tube (Choice D) without taking action may result in worsening of the air leak. Therefore, the priority intervention is to tighten the connections of the chest tube system.

5. What dietary recommendations should be provided to a patient with GERD?

• A. Avoid mint and spicy foods
• B. Eat large meals before bed
• C. Consume liquids with meals
• D. Avoid foods high in potassium

Correct answer: A

Rationale: The correct recommendation for a patient with GERD is to avoid mint and spicy foods. These types of foods can trigger acid reflux and worsen GERD symptoms. Choice B is incorrect as eating large meals before bed can increase the likelihood of acid reflux due to increased pressure on the lower esophageal sphincter. Choice C is also incorrect as consuming liquids with meals can cause distension in the stomach, potentially leading to reflux. Choice D is not directly related to GERD, as foods high in potassium are generally healthy and not specifically problematic for GERD patients.

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