Nursing Elites

1. A client with chronic renal failure is receiving peritoneal dialysis. The nurse should assess the client for which of the following complications?

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

Correct answer: B

Rationale: The correct answer is B: Hyperglycemia. In peritoneal dialysis, hyperglycemia can occur due to the glucose content of the dialysate solution. This high glucose concentration can lead to increased blood sugar levels in the client. Option A, Hypertension, is a common complication in chronic renal failure but is not directly related to peritoneal dialysis. Option C, Hypokalemia, is more commonly associated with loop diuretics or inadequate potassium intake. Option D, Hypernatremia, is more often seen in conditions of excessive sodium intake or water loss, rather than in peritoneal dialysis.

2. Which of the following qualifications is not required for a Nurse Supervisor at the provincial level?

• A. BSN, RN
• B. at least 3 years experience
• C. Master's in public health
• D. at least 5 years experience in public health

Correct answer: B

Rationale: The correct answer is B because the qualifications for a Nurse Supervisor at the provincial level include a BSN, RN, and a Master's in public health, along with a minimum of 5 years of experience in public health. Choice B, which states 'at least 3 years experience,' is incorrect as the requirement is for at least 5 years of experience in public health. Choices A, C, and D are necessary qualifications for a Nurse Supervisor at the provincial level based on the provided information.

3. The nurse is screening children at a local community health clinic for infectious diseases. Which child is at highest risk for hepatitis B virus (HBV)?

• A. A newborn.
• B. A 3-year-old.
• C. A 7-year-old.
• D. An 11-year-old.

Correct answer: A

Rationale: The correct answer is A: a newborn. Newborns are at the highest risk for HBV due to potential transmission from the mother. The hepatitis B virus can be transmitted from an infected mother to her baby during childbirth. Choices B, C, and D are incorrect because newborns have a higher risk due to this mode of transmission, making them more vulnerable compared to older children.

4. 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.

5. A hospitalized child suddenly has a seizure while his family is visiting. The nurse notes whole body rigidity followed by general jerking movements. The child vomits immediately after the seizure. A priority nursing diagnosis for the child is

• A. High risk for infection related to vomiting
• B. Altered family processes related to chronic illness
• C. Fluid volume deficit related to vomiting
• D. Risk for aspiration related to loss of consciousness

Correct answer: D

Rationale: Risk for aspiration is a priority concern following a seizure, especially when the child vomits, as there is a danger of aspirating the vomit into the lungs, leading to respiratory complications. The other options are not the priority in this situation. While infection risk and fluid volume deficit are important, ensuring the child's airway is clear and there is no risk of aspiration takes precedence. Altered family processes may be a concern but addressing the immediate physiological risk is the priority.

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