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. What are the signs and symptoms of Increased Intracranial Pressure (IICP)?

• A. Irritability, confusion, restlessness
• B. Fatigue and SOB
• C. Changes in pupillary response
• D. Elevated blood pressure

Correct answer: A

Rationale: The correct answer is A: Irritability, confusion, restlessness. These are common signs of Increased Intracranial Pressure (IICP) as they result from the increased pressure on brain tissue. Choices B, C, and D are incorrect. Fatigue and shortness of breath (SOB) are not typical symptoms of IICP. Changes in pupillary response can be seen in other conditions but are not specific to IICP. Elevated blood pressure is not a common sign of IICP.

3. What ECG changes are seen in hypokalemia?

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

Correct answer: A

Rationale: The correct answer is A: Flattened T waves on the ECG. Flattened T waves are an early indicator of hypokalemia on an ECG. Choice B, Elevated ST segments, is not typically seen in hypokalemia but can be a sign of myocardial infarction. Choice C, Widened QRS complex, is more commonly associated with hyperkalemia. Choice D, Prominent U waves, is typically associated with hypokalemia, but flattened T waves are considered a more specific and early sign.

4. What is the priority dietary modification for a patient with pre-dialysis end-stage kidney disease?

• A. Limit phosphorus intake to 700 mg/day
• B. Increase potassium intake to 3 g/day
• C. Eat three large meals per day
• D. Restrict protein intake to 1 g/kg/day

Correct answer: A

Rationale: The correct answer is A: Limit phosphorus intake to 700 mg/day. In patients with pre-dialysis end-stage kidney disease, restricting phosphorus intake is crucial to manage their condition. Excessive phosphorus can lead to mineral and bone disorders, which are common in kidney disease. Choice B, increasing potassium intake, is not the priority and can be harmful as kidney disease often leads to hyperkalemia. Choice C, eating three large meals per day, is not recommended as smaller, frequent meals are usually better tolerated. Choice D, restricting protein intake to 1 g/kg/day, is important in later stages of kidney disease but is not the priority at the pre-dialysis stage.

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

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

Correct answer: B

Rationale: Synchronized cardioversion is the preferred electrical intervention for ventricular tachycardia with a pulse. In this scenario, the heart still has an organized rhythm, so synchronized cardioversion is used to deliver a shock at a specific point in the cardiac cycle, aiming to restore a normal rhythm. Defibrillation (Choice A) is used for pulseless ventricular tachycardia or ventricular fibrillation. Pacing (Choice C) may be used for bradycardias or certain types of heart blocks. Medication administration (Choice D) can be considered for stable ventricular tachycardia, but synchronized cardioversion is the primary intervention for ventricular tachycardia with a pulse.

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