Nursing Elites

1. A client with a history of hypertension is receiving enalapril (Vasotec). The nurse should monitor the client for which of the following side effects?

• A. Hyperkalemia
• B. Hypoglycemia
• C. Hypercalcemia
• D. Hypokalemia

Correct answer: A

Rationale: The correct answer is A: Hyperkalemia. Enalapril, an ACE inhibitor, can lead to hyperkalemia as a side effect. ACE inhibitors can cause potassium retention by inhibiting aldosterone secretion, which may result in elevated potassium levels. Hypoglycemia (choice B) is not typically associated with enalapril use. Hypercalcemia (choice C) is also not a common side effect of enalapril. Hypokalemia (choice D) is the opposite of what is expected with enalapril, as it tends to cause potassium retention.

2. A client with rheumatoid arthritis is receiving methotrexate (Rheumatrex). The nurse should monitor the client for which of the following adverse effects?

• A. Leukopenia
• B. Hyperglycemia
• C. Hypertension
• D. Hypokalemia

Correct answer: A

Rationale: The correct answer is A: Leukopenia. Methotrexate, used in the treatment of rheumatoid arthritis, can lead to bone marrow suppression, resulting in leukopenia. This condition increases the risk of infections due to decreased white blood cell count. Choices B, C, and D are incorrect because methotrexate is not known to cause hyperglycemia, hypertension, or hypokalemia as its primary adverse effects.

3. With an alert of an internal disaster and the need for beds, the charge nurse is asked to list clients who are potential discharges within the next hour. Which client should the charge nurse select?

• A. An elderly client who has had type 2 diabetes for over 20 years, admitted with diabetic ketoacidosis 24 hours ago
• B. An adolescent admitted the prior night with Tylenol intoxication
• C. A middle-aged client with an internal automatic defibrillator and complaints of 'passing out at unknown times' admitted yesterday
• D. A school-age child diagnosed with suspected bacterial meningitis and was admitted at the change of shifts

Correct answer: A

Rationale: The correct answer is A because a client with diabetic ketoacidosis (DKA) that is being well-managed and has shown improvement within 24 hours is more stable and can be considered for discharge sooner than those with more acute or unstable conditions. Choice B is incorrect as Tylenol intoxication may require further monitoring and intervention. Choice C is incorrect as a client with an automatic defibrillator and episodes of passing out needs careful evaluation and monitoring. Choice D is incorrect as suspected bacterial meningitis is a serious condition that typically requires a longer hospital stay for treatment and observation.

4. While explaining an illness to a 10-year-old, what should the nurse keep in mind about the cognitive development at this age?

• A. They are able to make simple associations of ideas
• B. They are able to think logically in organizing facts
• C. Interpretation of events originates from their own perspective
• D. Conclusions are based on previous experiences

Correct answer: B

Rationale: Correct answer: At the age of 10, children are in the stage of concrete operational thought, where they can think logically and organize facts. Choice A is incorrect as simple associations of ideas are more characteristic of earlier developmental stages. Choice C is incorrect as while children at this age are developing perspective-taking skills, their interpretations are not solely limited to their own perspective. Choice D is incorrect as while previous experiences influence their thinking, the ability to think logically and organize facts is more prominent in this stage of cognitive development.

5. The nurse is planning a nutrition class for a group of high school students emphasizing the goals for nutrition from Healthy People 2020. Which meal selection provides the best choices in meeting these goals?

• A. pasta with cheese sauce, garlic butter bread, and vegetable juice drink
• B. a 6-oz pork chop, creamed peas, cheese sauce on potatoes, coffee
• C. vegetable lasagna, lettuce salad, a whole wheat roll, 8 oz of 2% milk
• D. bacon, lettuce, tomato sandwich, whole grain chips, 8 oz. of whole milk

Correct answer: C

Rationale: The correct answer is C because vegetable lasagna, lettuce salad, and a whole wheat roll with 2% milk align with the nutrition goals of Healthy People 2020. These choices provide a balanced meal with vegetables, whole grains, and dairy, promoting a healthier dietary pattern. Choices A, B, and D do not offer as comprehensive a selection of food groups or as healthy options as choice C, making them less aligned with the nutrition goals of Healthy People 2020.

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