Nursing Elites

1. What is the most common side effect of diuretics such as furosemide (Lasix)?

• A. Hypokalemia.
• B. Hyperkalemia.
• C. Hypernatremia.
• D. Hyponatremia.

Correct answer: A

Rationale: The correct answer is 'Hypokalemia.' Diuretics like furosemide increase the excretion of potassium, leading to hypokalemia as a common side effect. Hyperkalemia (choice B) is the opposite condition characterized by high potassium levels, which is not typically associated with furosemide use. Hypernatremia (choice C) is increased sodium levels, while hyponatremia (choice D) is decreased sodium levels, neither of which are the most common side effects of furosemide. Therefore, choice A is the best answer.

2. The nurse is teaching the main principles of hemodialysis to a client with chronic kidney disease. Which statement by the client indicates a need for further teaching by the nurse?

• A. My sodium level changes due to the movement from the blood into the dialysate.
• B. Dialysis works by the movement of wastes from higher to lower concentration.
• C. Extra fluid can be pulled from the blood by osmosis.
• D. The dialysate is similar to blood but without any toxins.

Correct answer: B

Rationale: The correct answer is B because dialysis works by the movement of solutes from an area of higher concentration to an area of lower concentration, which is known as diffusion. The other statements are accurate: A correctly describes the movement of sodium during hemodialysis, C explains the removal of excess fluid by osmosis, and D highlights the purpose of the dialysate in removing toxins from the blood.

3. A client with histoplasmosis has the following arterial blood gas (ABG) results: pH 7.30, PCO2 58 mm Hg, PO2 75 mm Hg, HCO3 27 mEq/L. Which of the following acid-base disturbances does the nurse recognize in these results?

• A. Metabolic acidosis
• B. Metabolic alkalosis
• C. Respiratory acidosis
• D. Respiratory alkalosis

Correct answer: A

Rationale: The client's ABG results show a low pH (acidosis) and an elevated PCO2, indicating respiratory acidosis. In respiratory acidosis, there is inadequate excretion of CO2, leading to increased PCO2 levels and a decrease in pH. Therefore, the correct answer is 'Metabolic acidosis'. Choices B, C, and D are incorrect. Metabolic alkalosis is characterized by elevated pH and bicarbonate levels. Respiratory acidosis involves low pH and high PCO2 levels, as seen in this case. Respiratory alkalosis is associated with high pH and low PCO2 levels.

4. A client has undergone insertion of a permanent pacemaker. When developing a discharge teaching plan, the nurse writes a goal of, 'The client will verbalize symptoms of pacemaker failure.' Which symptoms are most important to teach the client?

• A. Facial flushing.
• B. Fever.
• C. Pounding headache.
• D. Feelings of dizziness.

Correct answer: D

Rationale: The correct answer is 'D: Feelings of dizziness.' Feelings of dizziness may occur as a result of a decreased heart rate, leading to decreased cardiac output, which can be an indication of pacemaker failure. Teaching the client to recognize symptoms of decreased cardiac output, like dizziness, is crucial for early detection of pacemaker malfunction. Choices A, B, and C are less specific to pacemaker failure and are not commonly associated with this condition. Facial flushing, fever, and pounding headache are not typical signs of pacemaker failure and are not directly related to cardiac output, making them less relevant for teaching the client about pacemaker failure.

5. The patient is receiving sulfadiazine. The healthcare provider knows that this patient’s daily fluid intake should be at least which amount?

• A. 1000 mL/day
• B. 1200 mL/day
• C. 2000 mL/day
• D. 2400 mL/day

Correct answer: C

Rationale: Sulfadiazine may lead to crystalluria, a condition where crystals form in the urine. Adequate fluid intake helps prevent this adverse effect by ensuring urine is dilute enough to prevent crystal formation. The recommended daily fluid intake for a patient receiving sulfadiazine is at least 2000 mL/day. Choices A, B, and D are incorrect because they do not provide a sufficient amount of fluid intake to prevent crystalluria in patients on sulfadiazine.

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