Nursing Elites

1. Which of the following conditions is most commonly associated with a high risk of stroke?

• A. Hypertension.
• B. Diabetes.
• C. Obesity.
• D. Smoking.

Correct answer: A

Rationale: Hypertension is the correct answer. Hypertension, also known as high blood pressure, is a major risk factor for stroke because it puts increased pressure on blood vessels in the brain, making them more prone to damage and increasing the likelihood of a stroke. While diabetes, obesity, and smoking are also risk factors for stroke, hypertension is the most commonly associated condition with a high risk of stroke due to its direct impact on the blood vessels.

2. The provider has ordered Kayexalate and sorbitol to be administered to a patient. The nurse caring for this patient would expect which serum electrolyte values prior to administration of this therapy?

• A. Sodium 125 mEq/L and potassium 2.5 mEq/L
• B. Sodium 150 mEq/L and potassium 3.6 mEq/L
• C. Sodium 135 mEq/L and potassium 6.9 mEq/L
• D. Sodium 148 mEq/L and potassium 5.5 mEq/L

Correct answer: C

Rationale: Severe hyperkalemia, with a potassium level of 6.9 mEq/L, requires aggressive treatment with Kayexalate and sorbitol to increase the body’s excretion of potassium. The normal range for serum potassium is 3.5 to 5.5 mEq/L, so patients with the other potassium levels would not be treated aggressively or would need potassium supplementation. Therefore, option C (Sodium 135 mEq/L and potassium 6.9 mEq/L) is the correct choice as it indicates severe hyperkalemia warranting the administration of Kayexalate and sorbitol. Options A, B, and D have either potassium levels within normal limits, which would not necessitate this aggressive treatment, or potassium levels that are lower than what would typically prompt the need for Kayexalate and sorbitol.

3. A healthcare professional is reviewing the results of serum laboratory studies of a client with suspected hepatitis. Which increased parameter is interpreted as the most specific indicator of this disease?

• A. Hemoglobin
• B. Serum bilirubin
• C. Blood urea nitrogen (BUN)
• D. Erythrocyte sedimentation rate (ESR)

Correct answer: B

Rationale: Serum bilirubin is the most specific indicator of hepatitis as it reflects liver dysfunction. Hemoglobin, blood urea nitrogen (BUN), and erythrocyte sedimentation rate (ESR) are not specific to hepatitis. Hemoglobin measures the oxygen-carrying capacity of red blood cells, BUN evaluates kidney function, and ESR is a nonspecific marker of inflammation or infection.

4. The nurse is preparing to administer intravenous gentamicin to an infant through an intermittent needle. The nurse notes that the infant has not had a wet diaper for several hours. The nurse will perform which action?

• A. Administer the medication and give the infant extra oral fluids.
• B. Contact the provider to request adding intravenous fluids when giving the medication.
• C. Give the medication and obtain a serum peak drug level 45 minutes after the dose.
• D. Hold the dose and contact the provider to request a serum trough drug level.

Correct answer: D

Rationale: In this scenario, the infant not having a wet diaper for several hours indicates a potential decrease in urine output, which can be a sign of nephrotoxicity related to gentamicin. The correct action for the nurse is to hold the dose and contact the provider to request a serum trough drug level. This is important to monitor the drug levels and ensure that they are not reaching toxic levels. Administering the medication without addressing the decreased urine output could potentially lead to further nephrotoxicity. Contacting the provider to add intravenous fluids or obtaining a serum peak drug level are not the most appropriate actions in this situation as the priority is to assess for potential nephrotoxicity and ensure patient safety.

5. The nurse is caring for a client who is receiving an IV infusion of normal saline and notices that the infusion is not flowing. The insertion site is not inflamed or swollen. What should the nurse do first?

• A. Check the tubing for kinks or obstructions.
• B. Increase the flow rate to improve the infusion.
• C. Reinsert the IV catheter in another vein.
• D. Call the physician for further instructions.

Correct answer: A

Rationale: The correct first action for the nurse to take when an IV infusion is not flowing despite a normal insertion site is to check the tubing for kinks or obstructions. This step is crucial to ensure that there are no preventable issues impeding the flow of the IV solution. Increasing the flow rate without addressing potential obstructions could lead to complications such as infiltration. Reinserting the IV catheter in another vein should only be considered after ruling out tubing issues. Calling the physician for further instructions is not necessary at this stage as troubleshooting the tubing should be the initial intervention.

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