Nursing Elites

1. A 58-year-old client who has been post-menopausal for five years is concerned about the risk for osteoporosis because her mother has the condition. Which information should the nurse offer?

• A. Osteoporosis is a progressive genetic disease with no effective treatment.
• B. Calcium loss from bones can be slowed by increasing calcium intake and exercise.
• C. Estrogen replacement therapy should be started to prevent the progression of osteoporosis.
• D. Low-dose corticosteroid treatment effectively halts the course of osteoporosis.

Correct answer: B

Rationale: Post-menopausal females are at risk for osteoporosis due to the cessation of estrogen secretion. While genetics can play a role, osteoporosis is not solely a genetic disease. Increasing calcium intake, along with vitamin D supplementation and weight-bearing exercise, can help prevent further bone loss by slowing down calcium loss from bones. Estrogen replacement therapy is no longer recommended as a first-line treatment for osteoporosis due to associated risks. Corticosteroid treatment is not typically used as a primary treatment for osteoporosis.

2. The nurse is preparing to administer doses of hydrochlorothiazide (HydroDIURIL) and digoxin (Lanoxin) to a patient who has heart failure. The patient reports having blurred vision. The nurse notes a heart rate of 60 beats per minute and a blood pressure of 140/78 mm Hg. Which action will the nurse take?

• A. Administer the medications and request an order for serum electrolytes.
• B. Give both medications and evaluate serum blood glucose frequently.
• C. Hold the digoxin and notify the provider.
• D. Hold the hydrochlorothiazide and notify the provider.

Correct answer: C

Rationale: In this scenario, the patient is experiencing symptoms of digoxin toxicity, such as blurred vision and bradycardia. When thiazide diuretics like hydrochlorothiazide are taken with digoxin, the patient is at risk of digoxin toxicity due to the potential for thiazides to cause hypokalemia. Therefore, the correct action for the nurse to take is to hold the digoxin and notify the provider. Administering the medications without addressing the potential toxicity could worsen the patient's condition. Requesting serum electrolytes (Choice A) may be necessary but holding the digoxin takes priority. Evaluating serum blood glucose (Choice B) is not relevant to the current situation. Holding hydrochlorothiazide (Choice D) is not the best option as the primary concern is the digoxin toxicity that needs to be addressed promptly.

3. Which of the following is most important for assessing when evaluating the effects of peritoneal dialysis?

• A. Serum potassium levels
• B. Blood pressure
• C. Daily weight
• D. Serum sodium levels

Correct answer: C

Rationale: Daily weight is the most crucial parameter to assess when evaluating the effects of peritoneal dialysis because it directly reflects fluid balance. Peritoneal dialysis involves the removal of excess fluid and waste products from the body. Monitoring daily weight enables the healthcare provider to track changes in fluid status, ensuring that the dialysis treatment is effective. While serum potassium levels, blood pressure, and serum sodium levels are important parameters to monitor in patients undergoing dialysis, they are not as directly indicative of the immediate effects of peritoneal dialysis on fluid balance as daily weight.

4. A client who had a C-5 spinal cord injury 2 years ago is admitted to the emergency department with the diagnosis of autonomic dysreflexia secondary to a full bladder. Which assessment finding should the nurse expect this client to exhibit?

• A. Complaints of chest pain and shortness of breath
• B. Hypotension and venous pooling in the extremities
• C. Profuse diaphoresis and severe, pounding headache
• D. Pain and burning sensation upon urination and hematuria

Correct answer: C

Rationale: Autonomic dysreflexia is a life-threatening condition commonly seen in clients with spinal cord injuries above the T6 level. It is characterized by a sudden onset of excessively high blood pressure due to a noxious stimulus below the level of injury, often a distended bladder. The exaggerated sympathetic response leads to vasoconstriction, resulting in symptoms such as profuse diaphoresis (sweating) and a severe, pounding headache. These symptoms are the body's attempt to lower blood pressure. Complaints of chest pain and shortness of breath (Choice A) are not typical findings in autonomic dysreflexia. Hypotension and venous pooling (Choice B) are opposite manifestations of autonomic dysreflexia, which is characterized by hypertension. Pain and burning sensation upon urination and hematuria (Choice D) are indicative of a urinary tract infection and not specific to autonomic dysreflexia.

5. In a patient with diabetes, which of the following is a sign of hypoglycemia?

• A. Polydipsia
• B. Polyuria
• C. Dry skin
• D. Sweating

Correct answer: D

Rationale: Sweating is a common sign of hypoglycemia in patients with diabetes. When blood sugar levels drop too low, the body releases stress hormones like adrenaline, leading to symptoms such as sweating, shakiness, and palpitations. Polydipsia (excessive thirst) and polyuria (excessive urination) are more commonly associated with hyperglycemia (high blood sugar levels) in diabetes. Dry skin is not a typical symptom of hypoglycemia.

Similar Questions