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. A healthcare professional is assessing postoperative circulation of the lower extremities for a client who had knee surgery. The healthcare professional should test which of the following?

• A. Range of motion
• B. Skin color
• C. Edema
• D. Skin temperature

Correct answer: B

Rationale: Corrected Rationale: Assessing skin color is crucial to evaluate perfusion and circulation postoperatively. Skin color changes can indicate compromised circulation, such as pallor or cyanosis. Edema may suggest fluid retention but is not a direct indicator of circulation status. Range of motion is more related to joint function and mobility, not specifically circulation.

3. A client with chronic kidney disease is receiving epoetin alfa (Epogen). Which laboratory value should the LPN/LVN monitor to determine the effectiveness of this medication?

• A. Serum potassium
• B. Hemoglobin
• C. Serum creatinine
• D. Blood urea nitrogen (BUN)

Correct answer: B

Rationale: The correct answer is B: Hemoglobin. Monitoring hemoglobin levels is essential to assess the effectiveness of epoetin alfa in clients with chronic kidney disease. Epoetin alfa is a medication that stimulates red blood cell production, aiming to increase hemoglobin levels and improve symptoms of anemia in these patients. Monitoring serum potassium (Choice A) is important in clients with kidney disease, but it is more related to assessing electrolyte balance rather than the direct effectiveness of epoetin alfa. Serum creatinine (Choice C) and blood urea nitrogen (Choice D) are kidney function tests that help evaluate kidney health but do not specifically reflect the effectiveness of epoetin alfa therapy.

4. A client is admitted with acute pyelonephritis. Which symptom should the nurse expect the client to report?

• A. Flank pain
• B. Pedal edema
• C. Hypotension
• D. Weight gain

Correct answer: A

Rationale: Flank pain is a classic symptom of acute pyelonephritis, which is a bacterial infection of the kidney. It occurs due to inflammation and irritation of the renal capsule, leading to pain in the flank region. Pedal edema (swelling in the feet and ankles) is more commonly associated with conditions like heart failure or kidney disease, not typically seen in acute pyelonephritis. Hypotension (low blood pressure) is a systemic symptom that may occur with severe infections but is not a specific hallmark of pyelonephritis. Weight gain is also not a typical symptom of acute pyelonephritis; instead, patients may experience weight loss due to decreased appetite and systemic effects of infection.

5. A charge nurse is teaching a newly licensed nurse about the care of a client who has methicillin-resistant Staphylococcus aureus (MRSA). Which of the following statements should the charge nurse identify as an indication that the newly licensed nurse understands the teaching?

• A. I should obtain a specimen for culture and sensitivity after the first dose of an antimicrobial.
• B. MRSA is usually resistant to vancomycin, so another antimicrobial will be prescribed.
• C. I will protect others from exposure when I transport the client outside the room.
• D. To decrease resistance, antimicrobial therapy is discontinued when the client is no longer febrile.

Correct answer: C

Rationale: The correct answer is C. Protecting others from exposure when transporting a client with MRSA is crucial in preventing the spread of infection. This statement demonstrates understanding of infection control measures. Stating that MRSA is usually resistant to vancomycin (choice B) is incorrect; vancomycin is often effective against MRSA. Obtaining a specimen for culture and sensitivity after the first dose of an antimicrobial (choice A) is unnecessary and not indicated. Discontinuing antimicrobial therapy when the client is no longer febrile (choice D) is incorrect because antimicrobial therapy should be completed as prescribed to prevent the development of resistant strains.

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