Nursing Elites

1. A female client complains to the nurse at the health department that she has fatigue, shortness of breath, and lightheadedness. Her history reveals no significant medical problems. She states that she is always on a fad diet without any vitamin supplements. Which tests should the nurse expect the client to have first?

• A. peptic ulcer studies
• B. complete blood count, including hematocrit and hemoglobin
• C. genetic testing
• D. hemoglobin electrophoresis

Correct answer: B

Rationale: The correct answer is to perform a complete blood count, including hematocrit and hemoglobin, as the initial tests to assess the client's symptoms related to fatigue, shortness of breath, and lightheadedness. These symptoms can be indicative of anemia, which can be caused by nutritional deficiencies due to fad dieting without vitamin supplements. Peptic ulcer studies, genetic testing, and hemoglobin electrophoresis are not the most appropriate initial tests for the client's presenting symptoms and history. Peptic ulcer studies are not relevant to the client's symptoms. Genetic testing is not indicated based on the client's presentation and history. Hemoglobin electrophoresis is used to diagnose specific types of anemia and is not the first-line test in this scenario. Further testing decisions should be based on the results of the initial tests, the client's history, and other relevant factors.

2. Which symptoms is the client who overdosed on barbiturates most likely to exhibit?

• A. Bradypnea and bradycardia
• B. Hyperthermia and drowsiness
• C. Hyperreflexia and slurred speech
• D. Tachycardia and psychosis

Correct answer: A

Rationale: The correct answer is bradypnea and bradycardia. Barbiturates are central nervous system (CNS) depressants, which will slow down the respiratory rate (bradypnea) and heart rate (bradycardia). Choice B, hyperthermia and drowsiness, is incorrect as barbiturate overdose typically does not cause hyperthermia but rather hypothermia. Hyperreflexia and slurred speech (Choice C) are more indicative of stimulant overdoses rather than CNS depressants like barbiturates. Tachycardia and psychosis (Choice D) are also not typically seen in barbiturate overdose, as these drugs tend to depress the CNS rather than cause symptoms of increased heart rate or psychosis.

3. When administering intravenous electrolyte solution, which of the following precautions should the nurse take?

• A. Infuse hypertonic solutions cautiously.
• B. Mix no more than 60 mEq of potassium per liter of fluid.
• C. Prevent infiltration of calcium, which causes tissue necrosis and sloughing.
• D. Monitor the client's digitalis dosage for potential adjustments due to IV calcium administration.

Correct answer: C

Rationale: When administering intravenous electrolyte solutions, it is crucial to prevent infiltration of calcium to avoid tissue necrosis and sloughing. Hypertonic solutions should be infused cautiously (Choice A) to prevent adverse effects. The correct amount of potassium to be mixed in a liter of fluid is no more than 60 mEq, making Choice B incorrect. While monitoring the client's digitalis dosage for potential adjustments due to IV calcium administration is important, the statement suggesting an increased dosage is incorrect as IV calcium diminishes digitalis's action, making Choice D incorrect.

4. While undergoing hemodialysis, the client becomes restless and tells the nurse he has a headache and feels nauseous. Which of the following complications does the nurse suspect?

• A. Infection.
• B. Disequilibrium syndrome.
• C. Air embolus.
• D. Infection.

Correct answer: C

Rationale: In this scenario, the client undergoing hemodialysis is experiencing symptoms like restlessness, a headache, and nausea. These symptoms are indicative of an air embolus, a serious complication that can occur during hemodialysis. Air embolus happens when air enters the bloodstream and can lead to symptoms like restlessness, a headache, and nausea. It is crucial for the nurse to suspect and address this complication promptly to prevent further harm to the client. Choices A and D (Infection) are less likely in this case, as the symptoms presented are more suggestive of an air embolus rather than an infection. Choice B (Disequilibrium syndrome) is also less likely as the symptoms described are not typical of this syndrome. Therefore, the correct answer is C: Air embolus.

5. A client newly diagnosed with Diabetes Mellitus needs education. Which of the following statements should the nurse include in this education?

• A. "You can eat anything you want, but avoid foods with sugar."?
• B. "You need to lose weight, so your diet must be controlled."?
• C. "You need a diet and exercise program."?
• D. "You must reduce salt, fat, and sugar intake in your diet."?

Correct answer: C

Rationale: A client newly diagnosed with Diabetes Mellitus requires education on managing their condition. Choice C is the correct answer because it emphasizes the importance of a comprehensive approach involving both diet and exercise. This holistic approach is crucial in managing blood sugar levels and overall health for individuals with diabetes. Choice A is incorrect as it provides misleading information by suggesting that the client can eat anything as long as it doesn't contain sugar, which is not accurate for diabetes management. Choice B is not the best option as it focuses solely on weight loss rather than addressing the holistic needs of a diabetic individual. Choice D is incorrect as it suggests eliminating all salt, fat, and sugar, which is an extreme approach and not a realistic or balanced way to manage diabetes.

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