Nursing Elites

1. A client with chronic kidney disease (CKD) is experiencing hyperkalemia. Which intervention should the nurse implement to address this condition?

• A. Administer calcium gluconate.
• B. Encourage a diet high in potassium.
• C. Provide potassium supplements.
• D. Restrict sodium intake.

Correct answer: A

Rationale: Administering calcium gluconate is the appropriate intervention for a client with hyperkalemia. Calcium gluconate helps stabilize the heart by counteracting the effects of high potassium levels and reducing the risk of cardiac complications in individuals with hyperkalemia. Choices B, C, and D are incorrect. Encouraging a diet high in potassium or providing potassium supplements would exacerbate hyperkalemia. Restricting sodium intake is not directly related to addressing hyperkalemia.

2. A patient with chronic obstructive pulmonary disease (COPD) is prescribed ipratropium. What is the primary action of this medication?

• A. Reduce inflammation
• B. Relieve bronchospasm
• C. Suppress cough
• D. Thin respiratory secretions

Correct answer: B

Rationale: Ipratropium is an anticholinergic bronchodilator that primarily works to relieve bronchospasm by dilating the airways and improving airflow in patients with COPD. It does not have a significant effect on reducing inflammation, suppressing cough, or thinning respiratory secretions.

3. When evaluating a client's understanding of wearing a Holter monitor, which statement made by the client would indicate to the nurse that the client understands the procedure?

• A. I must record any symptoms occurring with my activity.
• B. I am not looking forward to staying in bed for 24 hours.
• C. I really am dreading the frequent blood drawing.
• D. I know that I shouldn't get close to my microwave oven.

Correct answer: A

Rationale: The correct answer is A. Recording symptoms that occur with activity is crucial when wearing a Holter monitor. This information helps in correlating symptoms with cardiac events, aiding in the diagnosis and treatment of the client's condition. The client's understanding of this aspect demonstrates comprehension of the procedure and its purpose.

4. What is an important teaching point for a patient prescribed dabigatran for atrial fibrillation?

• A. Take the medication with food to enhance absorption.
• B. Do not crush or chew the capsules.
• C. Increase intake of green leafy vegetables.
• D. Avoid all dairy products.

Correct answer: B

Rationale: The correct teaching point for a patient prescribed dabigatran is not to crush or chew the capsules. Doing so can alter the absorption of the medication, increasing the risk of bleeding. It is important for patients to swallow the capsules whole to ensure proper delivery of the medication.

5. The client has undergone a thyroidectomy, and the nurse is providing care. Which assessment finding requires immediate intervention?

• A. Hoarseness and a sore throat.
• B. Difficulty swallowing.
• C. Numbness and tingling around the mouth.
• D. Temperature of 100.2°F (37.9°C).

Correct answer: C

Rationale: Numbness and tingling around the mouth can indicate hypocalcemia, a common complication post-thyroidectomy due to inadvertent parathyroid gland removal. Immediate intervention is required to prevent severe hypocalcemia manifestations like tetany or seizures. Hoarseness and a sore throat are common after a thyroidectomy due to surgical trauma and irritation to the vocal cords, not requiring immediate intervention. Difficulty swallowing can be expected due to postoperative swelling or edema, but it should be monitored closely. A temperature of 100.2°F is a mild fever and may be a normal postoperative response, not necessitating immediate intervention unless accompanied by other concerning symptoms.

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