Nursing Elites

1. Which physiological acid-base balance complication would be most important for the nurse to assess in a patient with diarrhea?

• A. High serum pH
• B. Normal serum pH
• C. Metabolic alkalosis
• D. Metabolic acidosis

Correct answer: D

Rationale: The correct answer is metabolic acidosis. Diarrhea can lead to the loss of bicarbonate, causing an imbalance in the acid-base status of the body, specifically resulting in metabolic acidosis. High serum pH (choice A) is incorrect as diarrhea-induced bicarbonate loss would lower pH, not increase it. Normal serum pH (choice B) is not the best answer as diarrhea can disrupt the acid-base balance. Metabolic alkalosis (choice C) is an alkaline state, which is less likely to be caused by diarrhea.

2. How is family systems theory best described?

• A. The family is viewed as the sum of individual members
• B. A change in one family member cannot create a change in other members
• C. Individual family members are readily identified as the source of a problem
• D. When the family system is disrupted, change can occur at any point in the system

Correct answer: D

Rationale: Family systems theory views the family as a whole, where changes in one member affect the entire system, and changes can occur at any point within the system.

3. Nurses should be alert for increased fluid requirements in which circumstance?

• A. Fever
• B. Mechanical ventilation
• C. Congestive heart failure
• D. Increased intracranial pressure

Correct answer: A

Rationale: Fever increases metabolic rate, leading to insensible water loss, thus requiring increased fluid intake. Mechanical ventilation, CHF, and increased intracranial pressure generally require fluid restriction rather than increased fluid intake.

4. What measure of fluid balance status is most useful in a child with acute glomerulonephritis?

• A. Proteinuria
• B. Daily weight
• C. Specific gravity
• D. Intake and output

Correct answer: B

Rationale: Daily weight is the most accurate measure of fluid balance in children with acute glomerulonephritis, as it reflects changes in body fluid status more reliably than other measures like proteinuria or specific gravity.

5. What intervention is crucial during a sickle cell crisis in a child?

• A. Administer oxygen
• B. Apply cold compresses
• C. Restrict fluids
• D. Encourage bed rest

Correct answer: A

Rationale: Administering oxygen is crucial during a sickle cell crisis in a child as it helps to prevent further sickling of cells. Oxygen therapy can improve oxygen saturation levels, reducing the risk of tissue damage and complications. Applying cold compresses (choice B) is not recommended as it can potentially worsen vaso-occlusive crisis by causing vasoconstriction. Restricting fluids (choice C) is not appropriate as hydration is essential to prevent dehydration and maintain adequate blood flow. Encouraging bed rest (choice D) may be necessary but administering oxygen takes precedence in managing a sickle cell crisis.

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