Nursing Elites

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

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

Correct answer: A

Rationale: The correct answer is A: CD4 T-cell count below 180 cells/mm3. Monitoring the CD4 T-cell count is crucial in patients with HIV as it indicates the level of immunocompromise. A count below 180 cells/mm3 signifies severe immunocompromise and an increased risk of opportunistic infections. Choices B, C, and D are not the priority lab values in HIV management. While white blood cell count, serum albumin levels, and hemoglobin levels are important, they do not directly reflect the immune status and progression of HIV as the CD4 T-cell count does.

2. While administering a blood transfusion, a nurse suspects that the client is having an adverse reaction. Which of the following actions should the nurse take first?

• A. Maintain IV access
• B. Obtain the client's vital signs
• C. Contact the provider
• D. Stop the transfusion

Correct answer: D

Rationale: The correct first action for the nurse to take when suspecting an adverse reaction to a blood transfusion is to stop the transfusion immediately. Stopping the transfusion helps prevent further harm to the client. Maintaining IV access and obtaining vital signs are important steps but come after stopping the transfusion in this situation. Contacting the provider can be done after ensuring the client's safety by stopping the transfusion.

3. A patient who experienced an acute episode of gastritis should avoid which type of foods?

• A. Avoid foods high in potassium
• B. Avoid foods high in sodium
• C. Increase exercise
• D. Drink milk as a snack

Correct answer: A

Rationale: Patients who have experienced an acute episode of gastritis should avoid foods high in potassium. Potassium-rich foods can irritate the gastric lining, exacerbating gastritis symptoms. Therefore, choices B, C, and D are incorrect. Avoiding foods high in sodium is beneficial for other health conditions like hypertension, increasing exercise is generally good for overall health but not specifically for gastritis management, and drinking milk may provide temporary relief for some but is not a definitive recommendation for gastritis management.

4. What ECG changes are seen with hyperkalemia?

• A. Flattened T waves
• B. Elevated ST segments
• C. Prominent U waves
• D. Widened QRS complex

Correct answer: A

Rationale: Flattened T waves are an early ECG sign of hyperkalemia. Hyperkalemia affects the repolarization phase of the cardiac action potential, leading to changes such as peaked T waves, prolonged PR interval, widened QRS complex, and ultimately sine wave pattern. Elevated ST segments, prominent U waves, and widened QRS complex are not typically associated with hyperkalemia, making choices B, C, and D incorrect.

5. What adverse effect might occur in a patient receiving radiation after a mastectomy?

• A. Seizures
• B. JVD and fatigue
• C. SOB and JVD
• D. S3 heart sound

Correct answer: D

Rationale: The correct adverse effect that might occur in a patient receiving radiation after a mastectomy is the development of an S3 heart sound. This can result from decreased pumping ability following mastectomy and radiation treatment. Choice A, seizures, is incorrect as seizures are not a common adverse effect of radiation after a mastectomy. Choice B, JVD and fatigue, is incorrect as while fatigue can be a common side effect, JVD (Jugular Venous Distention) is not typically associated with radiation after a mastectomy. Choice C, SOB (Shortness of Breath) and JVD, is incorrect as while shortness of breath can occur, JVD is not a typical adverse effect of radiation post-mastectomy.

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