Nursing Elites

1. What is the first-line treatment for a patient experiencing wheezing and coughing due to an allergic reaction?

• A. Albuterol via nebulizer
• B. Methylprednisolone 100 mg IV
• C. Cromolyn 20 mg via nebulizer
• D. Aminophylline 500 mg IV

Correct answer: A

Rationale: The correct answer is A: Albuterol via nebulizer. Albuterol is the first-line treatment for wheezing caused by an allergic reaction as it quickly opens the airways, providing rapid relief. Choice B, Methylprednisolone 100 mg IV, is a systemic corticosteroid that may be used in severe cases to reduce inflammation but is not the initial treatment for acute wheezing. Choice C, Cromolyn 20 mg via nebulizer, is a mast cell stabilizer that is more commonly used for prophylaxis rather than acute relief in allergic conditions. Choice D, Aminophylline 500 mg IV, is a bronchodilator that is less commonly used now due to its narrow therapeutic window and potential for toxicity, making it less preferred than Albuterol for initial treatment of wheezing.

2. What are the expected changes on an ECG for a patient with hypokalemia?

• A. Flattened T waves
• B. Prominent U waves
• C. ST elevation
• D. Wide QRS complexes

Correct answer: A

Rationale: Flattened T waves are an early sign of hypokalemia on an ECG. Hypokalemia primarily manifests as flattened T waves on an ECG. While prominent U waves can be seen in hypokalemia, they are not as specific as flattened T waves. ST elevation is more commonly associated with conditions like myocardial infarction rather than hypokalemia. Wide QRS complexes are typically not a feature of hypokalemia on an ECG.

3. What should be included in teaching for a patient with pre-dialysis end-stage kidney disease?

• A. Limit phosphorus intake to 700 mg/day
• B. Increase protein intake to 1g/kg/day
• C. Increase sodium intake
• D. Limit sodium to 1,500 mg/day

Correct answer: A

Rationale: The correct answer is to limit phosphorus intake to 700 mg/day for a patient with pre-dialysis end-stage kidney disease. Excessive phosphorus intake can lead to further complications in kidney disease, such as bone and cardiovascular issues. Choice B is incorrect as increasing protein intake can put additional stress on the kidneys due to the buildup of urea and other waste products. Choice C is incorrect because increasing sodium intake can worsen hypertension and fluid retention, common issues in kidney disease. Choice D is incorrect as limiting sodium intake is generally recommended in kidney disease to manage blood pressure and fluid balance.

4. A nurse at a provider's office is interviewing a client who has multiple sclerosis and has been taking dantrolene for several months. Which of the following client statements should the nurse identify as an indication that the medication is effective?

• A. I don't have muscle spasms as frequently.
• B. I haven't gotten any colds, even though it is flu season.
• C. I feel like my nerve pain has improved.
• D. It is easier to urinate now.

Correct answer: A

Rationale: The correct answer is A: 'I don't have muscle spasms as frequently.' Dantrolene is a medication that relaxes skeletal muscles and is commonly prescribed to treat muscle spasms in clients with multiple sclerosis. Therefore, a reduction in muscle spasms frequency would be an indication of the medication's effectiveness. Choices B, C, and D are incorrect because dantrolene is not indicated for preventing colds, improving nerve pain, or easing urination. The focus should be on the medication's intended purpose, which is to address muscle spasms in clients with multiple sclerosis.

5. A nurse is developing a plan of care for a client who will be placed in halo traction following surgical repair of the cervical spine. Which of the following interventions should the nurse include in the plan?

• A. Inspect the pin site every 4 hours
• B. Monitor the client's skin under the halo vest
• C. Ensure two personnel hold the halo device when repositioning the client
• D. Apply powder to the client's skin under the vest to decrease itching

Correct answer: B

Rationale: The correct answer is to monitor the client's skin under the halo vest. This is important to assess for signs of skin issues such as excessive sweating, redness, or blistering, which can lead to skin breakdown and infection. Choice A is incorrect because while inspecting the pin site is important, it should be done more frequently than every 4 hours. Choice C is incorrect as the halo device should be supported by the client's body weight, not personnel, when repositioning. Choice D is incorrect because applying powder frequently can increase the risk of skin irritation and infection.

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