Nursing Elites

1. What is the expected ECG finding in a patient with hypokalemia?

• A. Flattened T waves
• B. Elevated ST segments
• C. Widened QRS complexes
• D. Widened QRS complexes on the ECG

Correct answer: A

Rationale: The correct answer is A: Flattened T waves. In hypokalemia, there is a decrease in serum potassium levels, which can lead to various ECG changes. One of the classic ECG findings associated with hypokalemia is the presence of flattened T waves. These T wave abnormalities are typically seen in multiple leads. Choice B, elevated ST segments, is not a typical ECG finding in hypokalemia. Choice C, widened QRS complexes, is more commonly associated with hyperkalemia rather than hypokalemia. Choice D is redundant and not a standard way of describing ECG findings.

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

• A. An air leak
• B. Drainage in the chest tube
• C. A blocked chest tube
• D. Normal chest tube function

Correct answer: A

Rationale: Continuous bubbling in the water seal chamber of a chest tube indicates an air leak. This signifies that air is escaping from the patient's pleural space into the chest tube system rather than being evacuated properly. An air leak can lead to lung collapse or pneumothorax and requires immediate attention. Therefore, choice A is the correct answer. Choices B, C, and D are incorrect because continuous bubbling does not indicate normal chest tube function, drainage in the chest tube, or a blocked chest tube.

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

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

Correct answer: A

Rationale: In a patient with ventricular tachycardia and a pulse, synchronized cardioversion is the preferred electrical intervention. Synchronized cardioversion is used to treat unstable tachyarrhythmias like ventricular tachycardia with a pulse. Choice B, defibrillation, is used for pulseless ventricular tachycardia or ventricular fibrillation. Choice C, medication administration, may not provide immediate correction for unstable ventricular tachycardia. Choice D, pacing, is not the first-line treatment for ventricular tachycardia with a pulse.

5. What is the priority action if a patient experiences hypoglycemia after an insulin dose?

• A. Check the patient's blood glucose level
• B. Administer IV dextrose
• C. Document the incident
• D. Continue monitoring the patient

Correct answer: A

Rationale: The priority action when a patient experiences hypoglycemia after an insulin dose is to check the patient's blood glucose level. This is crucial to confirm hypoglycemia before initiating any treatment. While administering IV dextrose may be necessary if the patient's blood glucose level is critically low, confirming hypoglycemia is essential to guide appropriate interventions. Documenting the incident is important for documentation purposes but is not the immediate priority when the patient's safety is at risk. Continuing to monitor the patient is essential, but it should follow the confirmation and initial management of hypoglycemia.

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