Nursing Elites

1. Teaching about the need to avoid foods high in potassium is most important for which client?

• A. a client receiving diuretic therapy
• B. a client with an ileostomy
• C. a client with metabolic alkalosis
• D. a client with renal disease

Correct answer: D

Rationale: Clients with renal disease are predisposed to hyperkalemia and should avoid foods high in potassium. High potassium levels can further burden the kidneys and worsen the condition. Choices A, B, and C are incorrect because clients receiving diuretic therapy, with an ileostomy, or with metabolic alkalosis are at risk for hypokalemia, which is low potassium levels. Therefore, these clients should actually be encouraged to eat foods high in potassium to maintain adequate levels and prevent complications associated with hypokalemia.

2. Which of the following conditions places a client at risk for developing cirrhosis?

• A. Type I diabetes
• B. Alcoholism
• C. Leukemia
• D. Glaucoma

Correct answer: B

Rationale: Alcoholism places a client at risk for developing cirrhosis due to the liver damage caused by excessive alcohol consumption. Type I diabetes, leukemia, and glaucoma are not directly associated with cirrhosis. While diabetes can lead to other health complications, it does not directly cause cirrhosis. Leukemia is a type of blood cancer that does not affect the liver in a way that leads to cirrhosis. Glaucoma is an eye condition that has no direct link to cirrhosis.

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 patient had a pneumonectomy to the right lung performed 48 hours ago. Which of the following conditions most likely exists?

• A. Decreased breath sound volume
• B. Elevated tidal volume
• C. Elevated respiratory capacity
• D. Wheezing

Correct answer: A

Rationale: After a pneumonectomy, where a lung is surgically removed, there will be a decrease in breath sound volume on the affected side due to reduced airflow. This reduction in breath sound volume is expected as there is less lung tissue to produce sound. Choices B, C, and D are incorrect. Elevated tidal volume and respiratory capacity are not expected after a pneumonectomy, and wheezing is more commonly associated with conditions like asthma or bronchitis, not a recent pneumonectomy.

5. A client is admitted to the critical care unit after suffering from a massive cerebral vascular accident. The client's vital signs include BP 160/110, HR 42, Cheyne-Stokes respirations. Based on this assessment, the nurse anticipates the client to be in which acid-base balance?

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

Correct answer: A

Rationale: In this scenario, the client is exhibiting Cheyne-Stokes respirations, which are characterized by periods of deep breathing alternating with apnea. This pattern indicates respiratory insufficiency, resulting in an accumulation of carbon dioxide in the blood. The elevated BP and slow heart rate further support the respiratory insufficiency, leading to respiratory acidosis. Therefore, the correct answer is Respiratory acidosis. Choices B, C, and D are incorrect. Respiratory alkalosis is characterized by decreased carbon dioxide levels in the blood, which is not indicated by the client's presentation. Metabolic acidosis results from conditions such as renal failure or diabetic ketoacidosis and is not the primary imbalance in this case. Metabolic alkalosis is characterized by elevated pH and bicarbonate levels, which are not present in the client's vital signs.

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