Nursing Elites

1. Which electrolyte imbalance would be the nurse's priority concern in the burn client?

• A. Hypernatremia
• B. Hyperkalemia
• C. Hypoalbuminemia
• D. Hypermagnesemia

Correct answer: B

Rationale: The correct answer is hyperkalemia. In a burn client, the nurse's priority concern is hyperkalemia due to cell lysis, which releases potassium into the bloodstream. This can lead to dangerous levels of potassium in the blood. Hypernatremia (Choice A) is less likely in burn clients. Hypoalbuminemia (Choice C) can occur but is not the priority in the immediate management of a burn client. Hypermagnesemia (Choice D) is not typically associated with burn injuries.

2. A patient who has delivered an 8.2 lb. baby boy 3 days ago via c-section, reports white patches on her breast that aren't going away. Which of the following medications may be necessary?

• A. Nystatin
• B. Atropine
• C. Amoxil
• D. Lortab

Correct answer: A

Rationale: The patient is likely experiencing thrush, a fungal infection, which can present as white patches on the breast that persist. Nystatin is an antifungal medication commonly used to treat thrush. Therefore, the correct answer is Nystatin. Atropine is not indicated for this condition and is used for different purposes. Amoxil is an antibiotic and would not be effective against a fungal infection like thrush. Lortab is a pain medication and is not appropriate for treating thrush.

3. A patient has recently been prescribed Lidocaine Hydrochloride. Which of the following symptoms may occur with an overdose?

• A. Memory loss and lack of appetite
• B. Confusion and fatigue
• C. Heightened reflexes
• D. Tinnitus and spasticity

Correct answer: B

Rationale: The correct answer is 'Confusion and fatigue.' Lidocaine Hydrochloride, when taken in excess, can lead to symptoms such as confusion and fatigue. It affects the central nervous system, leading to these cognitive and physical impairments. Choice A ('Memory loss and lack of appetite') is incorrect because memory loss is not a common symptom of Lidocaine Hydrochloride overdose, and lack of appetite is not a typical effect. Choice C ('Heightened reflexes') is incorrect as Lidocaine Hydrochloride overdose usually depresses reflexes rather than heightening them. Choice D ('Tinnitus and spasticity') is incorrect as tinnitus and spasticity are not commonly associated with Lidocaine Hydrochloride overdose.

4. A client had a C5 spinal cord contusion that resulted in quadriplegia. Two days after the injury occurred, the nurse sees his mother crying in the waiting room. The mother asks the nurse whether her son will ever play football again. Which of the following is the best initial response?

• A. "Given time and motivation, your son may regain some function, but I will seek more information from the physician."?
• B. Maintain a calm demeanor and speech pattern while addressing the mother's concerns.
• C. "I'm not sure, but I'll call the physician to discuss this with you promptly."?
• D. "It's not beneficial for your son if you get upset."?

Correct answer: C

Rationale: The best initial response in this situation is to acknowledge the mother's concern, express uncertainty, and offer to obtain more information from the physician. By saying, "I'm not sure, but I'll call the physician to discuss this with you promptly,"? the nurse demonstrates empathy, honesty, and a commitment to providing accurate information. Offering vague reassurance (Choice A) may raise false hopes as outcomes for spinal cord injuries are unpredictable. While maintaining a calm demeanor (Choice B) is important, it does not directly address the mother's immediate need for information. Discouraging the mother from feeling upset (Choice D) is dismissive of her emotions and does not address her question, which is seeking information about her son's prognosis.

5. Which statement best describes electrolytes in intracellular and extracellular fluid?

• A. There is a greater concentration of sodium in extracellular fluid and potassium in intracellular fluid
• B. There is an equal concentration of sodium and potassium in extracellular fluid
• C. There is a greater concentration of potassium in extracellular fluid and sodium in intracellular fluid
• D. There is an equal concentration of sodium and potassium between intracellular and extracellular fluid

Correct answer: A

Rationale: Electrolytes are distributed unequally between intracellular and extracellular fluids. Sodium concentration is higher in extracellular fluid, while potassium concentration is higher in intracellular fluid. Therefore, the correct answer is 'There is a greater concentration of sodium in extracellular fluid and potassium in intracellular fluid.' Choices B, C, and D are incorrect because they do not accurately describe the typical distribution of sodium and potassium between intracellular and extracellular fluid.

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