Nursing Elites

1. Which of the following might result from severe diarrhea?

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

Correct answer: D

Rationale: The correct answer is D: Metabolic acidosis. Severe diarrhea can lead to metabolic acidosis because the loss of bicarbonate ions in the stool results in an overall decrease in the body's bicarbonate levels. Respiratory acidosis (choice A) is caused by retention of carbon dioxide, usually due to inadequate alveolar ventilation. Metabolic alkalosis (choice B) is characterized by elevated pH and bicarbonate levels, usually caused by conditions like vomiting. Respiratory alkalosis (choice C) is a condition of low blood carbon dioxide levels and high pH, often due to hyperventilation.

2. Which of the following would the nurse see in a client with thrombocytopenia?

• A. A decreased platelet cell count
• B. Decreased white blood cell count
• C. Increased red blood cell count
• D. An increased platelet cell count

Correct answer: A

Rationale: Thrombocytopenia is characterized by a decreased platelet cell count, leading to an increased risk of bleeding. Therefore, the correct answer is A. Choice B, a decreased white blood cell count, is not typically associated with thrombocytopenia. Choice C, an increased red blood cell count, is not a characteristic finding in thrombocytopenia. Choice D, an increased platelet cell count, is the opposite of what is observed in thrombocytopenia.

3. A newborn is diagnosed with congenital intrinsic factor deficiency. Which of the following types of anemia will the nurse see documented on the chart?

• A. Iron deficiency anemia
• B. Sideroblastic anemia
• C. Pernicious anemia
• D. Hemolytic anemia

Correct answer: C

Rationale: The correct answer is C, Pernicious anemia. Pernicious anemia is associated with a congenital intrinsic factor deficiency, leading to the impaired absorption of vitamin B12. Iron deficiency anemia (Choice A) is not directly related to intrinsic factor deficiency. Sideroblastic anemia (Choice B) is characterized by defective iron uptake by developing erythrocytes and is not linked to intrinsic factor deficiency. Hemolytic anemia (Choice D) involves the premature destruction of red blood cells and is not specifically associated with intrinsic factor deficiency.

4. A client with multiple sclerosis (MS) is experiencing a relapse. Which of the following factors is most likely contributing to the relapse?

• A. Taking an over-the-counter multivitamin
• B. Experiencing high levels of emotional stress
• C. Getting a flu shot
• D. Engaging in strenuous physical activity

Correct answer: B

Rationale: Emotional stress can trigger a relapse in multiple sclerosis by exacerbating symptoms. While taking an over-the-counter multivitamin and getting a flu shot are generally safe, they are not typically known to trigger MS relapses. Engaging in strenuous physical activity, if done carefully, can actually have benefits for individuals with MS by improving strength and mobility, so it is less likely to be the cause of a relapse.

5. During a flu shot clinic, one of the questions the student nurse asks relates to whether the client has a history of Guillain-Barré syndrome. The client asks, 'What is that?' How should the nursing student reply?

• A. A type of paralysis that affects movement on both sides of the body. It may even involve the respiratory muscles.
• B. Swelling of your arm where you got your flu shot and maybe your eyes and lips had some swelling as well.
• C. A degenerative disease where you have trouble walking without the help of a cane or walker.
• D. Influenza-like illness where you had fever and chills for 2 to 3 days after your last flu shot.

Correct answer: A

Rationale: The correct answer is A because Guillain-Barré syndrome is an acute immune-mediated polyneuropathy that can lead to paralysis affecting movement on both sides of the body, and in severe cases, involving the respiratory muscles. Choice B is incorrect as it describes local swelling, not the systemic effects of Guillain-Barré syndrome. Choice C is incorrect as it describes a degenerative disease affecting mobility, not an acute immune-mediated condition like Guillain-Barré syndrome. Choice D is incorrect as it describes flu-like symptoms following a flu shot, which is not the same as Guillain-Barré syndrome.

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