Nursing Elites

1. A client with chronic kidney disease is experiencing hyperkalemia. Which medication should the LPN/LVN anticipate being prescribed to lower the client's potassium level?

• A. Furosemide (Lasix)
• B. Sodium polystyrene sulfonate (Kayexalate)
• C. Calcium gluconate
• D. Albuterol (Proventil)

Correct answer: B

Rationale: The correct answer is B: Sodium polystyrene sulfonate (Kayexalate). Kayexalate is commonly used to lower potassium levels in clients with hyperkalemia by exchanging sodium ions for potassium ions in the large intestine, leading to the elimination of excess potassium from the body. Choice A, Furosemide (Lasix), is a loop diuretic that helps with fluid retention but does not directly lower potassium levels. Choice C, Calcium gluconate, is used to treat calcium deficiencies and does not impact potassium levels. Choice D, Albuterol (Proventil), is a bronchodilator used to treat respiratory conditions and does not affect potassium levels. Therefore, the LPN/LVN should anticipate the prescription of Kayexalate to address the client's hyperkalemia.

2. The healthcare provider prescribes furosemide (Lasix) 15 mg IV stat. On hand is Lasix 20 mg/2 ml. How many milliliters should the LPN/LVN administer?

• A. 1 ml.
• B. 1.5 ml.
• C. 1.75 ml.
• D. 2 ml.

Correct answer: B

Rationale: To calculate the correct dose of 15 mg, the LPN/LVN should administer 1.5 ml of Lasix (20 mg/2 ml). This calculation ensures precise dosing. Choice A (1 ml) is too low and would provide only 10 mg, while choice C (1.75 ml) and choice D (2 ml) would exceed the prescribed dose, resulting in potential adverse effects. It is important for the LPN/LVN to administer the exact prescribed dose to ensure therapeutic efficacy and avoid unnecessary complications.

3. A client with brain cancer is transferring to hospice care. The client's son tells the nurse, 'I don’t know what to tell my dad if he asks how he is going to die.' Which of the following is an appropriate response by the nurse?

• A. “Let’s talk more about your dad’s condition.”
• B. “The social worker will help you answer those questions.”
• C. “I think that you should discuss this with the hospice nurse.”
• D. “Try to help your dad enjoy this time as much as he can.”

Correct answer: D

Rationale: Choosing option D, 'Try to help your dad enjoy this time as much as he can,' is the most appropriate response by the nurse. This response shows empathy and compassion towards the client and their family during this difficult transition. The focus on supporting the client in enjoying their remaining time reflects a holistic approach to care. Options A, B, and C are not the best responses in this situation. Option A could lead to unnecessary details that might be overwhelming for the family. Option B shifts the responsibility to the social worker without providing immediate support. Option C deflects the son's concerns to another healthcare professional when emotional support is needed.

4. A nurse is planning care for a client who has fluid overload. Which of the following actions should the nurse plan to take first?

• A. Evaluate electrolytes
• B. Restrict fluid intake
• C. Administer diuretics
• D. Monitor vital signs

Correct answer: A

Rationale: When a client has fluid overload, the nurse's first action should be to evaluate electrolytes. Electrolyte levels can be significantly affected by fluid imbalances, and assessing them will guide the nurse in determining the appropriate interventions. Restricting fluid intake (choice B) may be necessary but is not the initial priority. Administering diuretics (choice C) should be based on the electrolyte evaluation and overall assessment. Monitoring vital signs (choice D) is essential but does not provide direct information on the client's electrolyte status, which is crucial in managing fluid overload.

5. A healthcare professional is providing care to a client who has a tracheostomy. Which of the following actions should the professional take to prevent complications?

• A. Clean around the stoma with povidone-iodine.
• B. Maintain sterile technique when performing tracheostomy care.
• C. Use clean technique when suctioning the tracheostomy.
• D. Change tracheostomy ties weekly.

Correct answer: B

Rationale: Maintaining sterile technique when performing tracheostomy care is essential in preventing infections and complications. Option A is incorrect because povidone-iodine may be too harsh for cleaning around the stoma and can lead to skin irritation. Option C is incorrect because suctioning a tracheostomy should be done using sterile technique to minimize the risk of introducing pathogens. Option D is incorrect as tracheostomy ties need to be changed more frequently, usually every 1-2 days, to prevent skin breakdown and infection.

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