Nursing Elites

1. What is the first medication to administer to a patient experiencing wheezing 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-choice medication for wheezing due to its fast-acting bronchodilatory effect, which helps in relieving the symptoms quickly. Choice B, Methylprednisolone 100 mg IV, is a corticosteroid used for its anti-inflammatory effects and would be beneficial in reducing inflammation in allergic reactions but is not the first-line treatment for wheezing. Choice C, Cromolyn 20 mg via nebulizer, is a mast cell stabilizer used to prevent asthma attacks but is not the immediate treatment for wheezing during an allergic reaction. Choice D, Aminophylline 500 mg IV, is a bronchodilator but is not typically the initial medication of choice for wheezing in an allergic reaction.

2. What lab value should be prioritized in a patient with HIV?

• A. CD4 T-cell count below 180 cells/mm3
• B. Hemoglobin levels
• C. Serum albumin levels
• D. White blood cell count

Correct answer: A

Rationale: The correct answer is A: CD4 T-cell count below 180 cells/mm3. In a patient with HIV, monitoring the CD4 T-cell count is crucial as it reflects the status of the immune system. A CD4 T-cell count below 200 cells/mm3 indicates severe immunocompromise and risk of opportunistic infections. Hemoglobin levels (choice B) are important for assessing anemia but do not directly reflect the immune status in HIV patients. Serum albumin levels (choice C) are indicators of nutritional status and inflammation, not specific to HIV disease progression. White blood cell count (choice D) may fluctuate due to various conditions and is not as specific as the CD4 T-cell count in assessing HIV progression.

3. What should the nurse monitor for in a patient with hypokalemia?

• A. Monitor for muscle weakness
• B. Check deep tendon reflexes (DTRs)
• C. Monitor for seizures
• D. Monitor for bradycardia

Correct answer: A

Rationale: The correct answer is to monitor for muscle weakness in a patient with hypokalemia. Hypokalemia, which is low potassium levels, can lead to muscle weakness due to its effects on neuromuscular function. Checking deep tendon reflexes (Choice B) is not typically associated with hypokalemia. Seizures (Choice C) are more commonly associated with low calcium levels rather than low potassium levels. Bradycardia (Choice D) is a symptom of hyperkalemia (high potassium levels) rather than hypokalemia.

4. A nurse is preparing to discharge a client who has a new diagnosis of chronic kidney disease (CKD). Which of the following referrals should the nurse plan to initiate?

• A. Respiratory therapy
• B. Hospice care
• C. Occupational therapy
• D. Dietary services

Correct answer: D

Rationale: The correct answer is D: Dietary services. Referring the client to dietary services is essential for managing nutrition, including monitoring sodium, potassium, and protein intake, which are crucial aspects of managing chronic kidney disease (CKD). Respiratory therapy (choice A) focuses on managing respiratory conditions, which are not directly related to CKD. Hospice care (choice B) is not appropriate for a new diagnosis of CKD as it is designed for end-of-life care. Occupational therapy (choice C) is beneficial for improving activities of daily living but is not the priority referral for a new CKD diagnosis.

5. What teaching should be provided to a patient after cataract surgery?

• A. Avoid NSAIDs
• B. Avoid bright lights
• C. Wear dark glasses while outdoors
• D. Use warm compresses

Correct answer: A

Rationale: The correct teaching to provide to a patient after cataract surgery is to avoid NSAIDs. NSAIDs should be avoided to reduce the risk of bleeding post-surgery. Choices B, C, and D are not directly related to post-cataract surgery care. Avoiding bright lights and wearing dark glasses while outdoors may be beneficial for eye comfort but are not specific postoperative instructions. Using warm compresses is also not a standard teaching after cataract surgery.

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