Nursing Elites

1. After a lumbar puncture, into which position does the nurse assist the client?

• A. Flat
• B. Semi-Fowler
• C. Side-lying with the head of the bed elevated
• D. Sitting up in a recliner with the feet elevated

Correct answer: A

Rationale: After a lumbar puncture, the client should be positioned flat. This position helps prevent post-procedure spinal headaches and cerebrospinal fluid leakage. Keeping the client flat for up to 12 hours is crucial in minimizing these risks. Choices B, C, and D are incorrect because elevating the head of the bed or sitting up can increase the risk of complications by altering the pressure in the spinal canal, potentially leading to headaches and fluid leakage.

2. The nurse is assessing a client with chronic kidney disease (CKD). Which finding is most important for the nurse to respond to first?

• A. Potassium 6.0 mEq/L.
• B. Daily urine output of 400 ml.
• C. Peripheral neuropathy.
• D. Uremic fetor.

Correct answer: A

Rationale: The correct answer is A. Potassium level of 6.0 mEq/L indicates hyperkalemia, which is a critical electrolyte imbalance in clients with chronic kidney disease. Hyperkalemia can lead to life-threatening arrhythmias, making it the priority finding to address. Choice B, a daily urine output of 400 ml, may indicate decreased kidney function but does not pose an immediate life-threatening risk compared to hyperkalemia. Peripheral neuropathy (Choice C) and uremic fetor (Choice D) are common manifestations of CKD but are not as urgent as addressing a potentially fatal electrolyte imbalance like hyperkalemia.

3. Which of the following interventions is most appropriate for a patient with left-sided heart failure?

• A. Administering IV fluids.
• B. Administering oxygen.
• C. Administering diuretics.
• D. Administering antihypertensives.

Correct answer: B

Rationale: Administering oxygen is the most appropriate intervention for a patient with left-sided heart failure because it helps improve oxygenation. In left-sided heart failure, the heart struggles to pump oxygen-rich blood to the body, leading to inadequate oxygen supply to tissues. Administering oxygen can help alleviate symptoms of hypoxia and reduce the workload on the heart. IV fluids (Choice A) may exacerbate heart failure by increasing fluid volume, diuretics (Choice C) are used to reduce fluid overload in heart failure, and antihypertensives (Choice D) are more suitable for managing hypertension, which may be a comorbidity in heart failure but are not the primary intervention for left-sided heart failure.

4. When providing care for an unconscious client who has seizures, which nursing intervention is most essential?

• A. Ensure oral suction is available.
• B. Maintain the client in a semi-Fowler's position.
• C. Provide frequent mouth care.
• D. Keep the room at a comfortable temperature.

Correct answer: A

Rationale: During seizures in an unconscious client, ensuring oral suction is available is crucial to managing secretions and preventing aspiration. This intervention helps maintain a clear airway and reduce the risk of complications. Maintaining the client in a semi-Fowler's position (Choice B) may be important for airway management but is not as critical as having oral suction ready. Providing frequent mouth care (Choice C) and keeping the room at a comfortable temperature (Choice D) are important aspects of overall care but are not as urgently needed as ensuring oral suction for managing secretions during seizures.

5. The nurse is preparing to administer trimethoprim-sulfamethoxazole (TMP-SMX) to a patient who is being treated for a urinary tract infection. The nurse learns that the patient has type 2 diabetes mellitus and takes a sulfonylurea oral antidiabetic drug. The nurse will monitor this patient closely for which effect?

• A. Headaches
• B. Hypertension
• C. Hypoglycemia
• D. Superinfection

Correct answer: C

Rationale: When a patient takes oral antidiabetic agents (sulfonylurea) along with sulfonamides like trimethoprim-sulfamethoxazole, it can lead to an increased hypoglycemic effect. Therefore, the nurse should monitor the patient closely for hypoglycemia. Headaches, hypertension, and superinfection are not typically associated with the interaction between sulfonamides and sulfonylureas. Examples of antidiabetic sulfonylurea medications include glipizide, glimepiride, glyburide, tolazamide, and tolbutamide.

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