Nursing Elites

1. After a session of hemodialysis, the nurse should monitor the client for which of the following complications of hemodialysis?

• A. Hyperkalemia.
• B. Hypotension.
• C. Infection.
• D. Fever.

Correct answer: B

Rationale: The correct answer is 'B: Hypotension.' Hypotension is a common complication of hemodialysis because fluid removal during the process can lead to a drop in blood pressure. The nurse should closely monitor the client for signs of hypotension such as dizziness, lightheadedness, or a decrease in blood pressure readings. Choice 'A: Hyperkalemia' is incorrect because hemodialysis actually helps lower potassium levels by removing excess potassium from the blood. Choice 'C: Infection' is incorrect as it is not a direct complication of hemodialysis but rather a risk associated with invasive procedures. Choice 'D: Fever' is incorrect as fever is not a typical immediate post-hemodialysis complication unless an underlying infection is present.

2. A nurse contacts the healthcare provider after reviewing a client’s laboratory results and noting a blood urea nitrogen (BUN) of 35 mg/dL and a creatinine of 1.0 mg/dL. For which action should the nurse recommend a prescription?

• A. Intravenous fluids
• B. Hemodialysis
• C. Fluid restriction
• D. Urine culture and sensitivity

Correct answer: A

Rationale: The normal range for BUN is 10 to 20 mg/dL, and for creatinine, it is 0.6 to 1.2 mg/dL in males and 0.5 to 1.1 mg/dL in females. Creatinine is a more specific marker for kidney function compared to BUN. In this case, the client's creatinine level is within the normal range, indicating a non-renal cause for the elevated BUN. Dehydration is a common cause of increased BUN, so the appropriate action would be to recommend intravenous fluids to address the dehydration. Fluid restriction is not indicated as the client needs hydration. Hemodialysis is not appropriate for dehydration and is typically reserved for renal failure. The laboratory results do not suggest an infection, making a urine culture and sensitivity unnecessary in this scenario.

3. After the administration of t-PA, what should the nurse do?

• A. Observe the client for chest pain.
• B. Monitor for fever.
• C. Review the 12-lead electrocardiogram (ECG).
• D. Auscultate breath sounds.

Correct answer: A

Rationale: After the administration of t-PA, the nurse should observe the client for chest pain. Chest pain post t-PA administration could indicate reocclusion of the coronary artery, a serious complication that requires immediate intervention. Monitoring for fever (choice B) is not specifically associated with t-PA administration. While reviewing the 12-lead ECG (choice C) is important for assessing cardiac function, it may not be the immediate priority right after t-PA administration. Auscultating breath sounds (choice D) is important for assessing respiratory status but is not the most crucial assessment following t-PA administration.

4. To assess the quality of an adult client's pain, what approach should the nurse use?

• A. Observe body language and movement.
• B. Ask the client to describe the pain.
• C. Identify effective pain relief measures.
• D. Provide a numeric pain scale.

Correct answer: B

Rationale: The correct answer is to ask the client to describe the pain. This approach allows the nurse to gather subjective information directly from the client, such as the quality, intensity, location, and factors that aggravate or alleviate the pain. Observing body language and movement (Choice A) can provide additional cues but may not fully capture the client's pain experience. Identifying effective pain relief measures (Choice C) and providing a numeric pain scale (Choice D) are important aspects of pain management but do not directly assess the quality of the client's pain.

5. Which of the following lipid abnormalities is a risk factor for the development of atherosclerosis and peripheral vascular disease?

• A. Low concentration of triglycerides.
• B. High levels of high-density lipoprotein (HDL) cholesterol.
• C. High levels of low-density lipoprotein (LDL) cholesterol.
• D. Low levels of LDL cholesterol.

Correct answer: C

Rationale: The correct answer is C: High levels of low-density lipoprotein (LDL) cholesterol. High levels of LDL cholesterol contribute to the development of atherosclerosis and peripheral vascular disease by being deposited in the blood vessel walls, leading to the formation of plaques that can obstruct blood flow. Choice A is incorrect as a low concentration of triglycerides is not typically associated with an increased risk of atherosclerosis or PVD. Choice B is incorrect as high levels of high-density lipoprotein (HDL) cholesterol are actually considered protective against atherosclerosis as it helps remove cholesterol from arteries. Choice D is incorrect as low levels of LDL cholesterol are not typically considered a risk factor for atherosclerosis or PVD.

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