Nursing Elites

1. A 48-year-old client with chronic alcoholism is admitted to the hospital. The nurse would anticipate that the client may be deficient in which vitamins?

• A. Vitamin B and vitamin C
• B. Vitamin D and vitamin E
• C. Vitamin K and vitamin A
• D. Vitamin A and vitamin E

Correct answer: A

Rationale: The correct answer is A. Chronic alcoholism commonly leads to deficiencies in B vitamins, particularly thiamine, and vitamin C. Thiamine deficiency can result in serious neurological issues like Wernicke-Korsakoff syndrome, while vitamin C deficiency can lead to scurvy. Choices B, C, and D are incorrect because vitamin D and E deficiencies are not typically associated with chronic alcoholism.

2. What pathophysiological events occur sequentially in the development of atherosclerosis?

• A. Foam cells release growth factors.
• B. Smooth muscle grows over fatty streaks creating fibrous plaques.
• C. Macrophages consume low-density lipoprotein (LDL) and create foam cells.
• D. Arterial endothelium injury causes inflammation.

Correct answer: D

Rationale: The correct sequence of pathophysiological events in the development of atherosclerosis starts with arterial endothelium injury causing inflammation. This inflammation triggers the formation of foam cells by macrophages consuming low-density lipoprotein (LDL). Subsequently, smooth muscle grows over fatty streaks, creating fibrous plaques. Therefore, option D is the correct answer. Choices A, B, and C are incorrect because they do not reflect the accurate chronological order of events in the pathogenesis of atherosclerosis.

3. A client with heart failure reports nausea, vomiting, yellow vision, and palpitations. What should the nurse assess first?

• A. Administer antiemetics to reduce nausea.
• B. Obtain a list of the client's cardiac medications.
• C. Perform an ECG to evaluate heart function.
• D. Review the client's dietary intake for possible causes.

Correct answer: B

Rationale: The combination of nausea, vomiting, yellow vision, and palpitations in a heart failure patient is indicative of digoxin toxicity. The nurse should first obtain a list of the client's medications to verify if they are taking digoxin.

4. A client at 12 weeks gestation is admitted to the antepartum unit with a diagnosis of hyperemesis gravidarum. Which action is most important for the nurse to implement?

• A. Provide emotional support
• B. Monitor daily weight
• C. Encourage small frequent meals
• D. Initiate prescribed intravenous fluids

Correct answer: D

Rationale: Hyperemesis gravidarum, characterized by severe nausea and vomiting, leads to dehydration and electrolyte imbalances. The priority intervention is initiating IV fluids to correct these imbalances. Providing emotional support is important for the client's well-being, but addressing fluid and electrolyte imbalances takes precedence. Monitoring daily weight and encouraging small frequent meals are beneficial interventions but are not the priority when managing hyperemesis gravidarum.

5. A client with a urinary tract infection is prescribed ciprofloxacin. What is the nurse's priority teaching?

• A. Take the medication with a full glass of water.
• B. Avoid direct sunlight while taking the medication.
• C. Take the medication with meals to prevent nausea.
• D. Discontinue the medication if you experience dizziness.

Correct answer: A

Rationale: The correct answer is A: 'Take the medication with a full glass of water.' It is crucial for the nurse to teach the client to take ciprofloxacin with a full glass of water to prevent crystalluria, a potential side effect of the medication. Choice B is incorrect because ciprofloxacin does not require avoiding direct sunlight. Choice C is incorrect as taking the medication with meals is not necessary to prevent nausea. Choice D is incorrect as dizziness is not a common reason to discontinue ciprofloxacin.

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