Nursing Elites

1. A healthcare provider is assessing a client who reports a possible exposure to HIV. Which of the following findings should the healthcare provider identify as an early manifestation of HIV infection?

• A. Stomatitis
• B. Fatigue
• C. Wasting syndrome
• D. Lipodystrophy

Correct answer: B

Rationale: The correct answer is 'B: Fatigue.' Early manifestations of HIV infection often include symptoms like fatigue, fever, and rash, which are typical of viral infections. Stomatitis (choice A) refers to inflammation of the mouth and lips, which can occur in HIV but is not specific to early infection. Wasting syndrome (choice C) and lipodystrophy (choice D) are more commonly associated with later stages of HIV infection rather than early manifestations.

2. What is the first-line treatment for a patient experiencing wheezing and coughing due to an allergic reaction?

• A. Albuterol via nebulizer
• B. Methylprednisolone 100 mg IV
• C. Cromolyn 20 mg via nebulizer
• D. Aminophylline 500 mg IV

Correct answer: A

Rationale: The correct answer is A: Albuterol via nebulizer. Albuterol is the first-line treatment for wheezing caused by an allergic reaction as it quickly opens the airways, providing rapid relief. Choice B, Methylprednisolone 100 mg IV, is a systemic corticosteroid that may be used in severe cases to reduce inflammation but is not the initial treatment for acute wheezing. Choice C, Cromolyn 20 mg via nebulizer, is a mast cell stabilizer that is more commonly used for prophylaxis rather than acute relief in allergic conditions. Choice D, Aminophylline 500 mg IV, is a bronchodilator that is less commonly used now due to its narrow therapeutic window and potential for toxicity, making it less preferred than Albuterol for initial treatment of wheezing.

3. What is an escharotomy and when is it performed?

• A. A surgical incision to release pressure in burn injuries
• B. A procedure to remove dead tissue from wounds
• C. An incision to improve circulation in tight skin after burns
• D. A procedure to remove excess fluid from the chest

Correct answer: A

Rationale: An escharotomy is a surgical incision made to release pressure in a part of the body that has a deep burn and excessive swelling. This procedure is crucial in preventing further damage due to restricted blood flow and compromised circulation. Choice B is incorrect because it describes debridement, which is the removal of dead tissue from wounds. Choice C is incorrect as it does not specifically address the purpose of relieving pressure in burn injuries. Choice D is incorrect as it describes a procedure more related to thoracentesis, which is the removal of excess fluid from the chest, typically the pleural space.

4. What are the expected findings in a patient with a thrombotic stroke?

• A. Gradual loss of function on one side of the body
• B. Sudden loss of consciousness
• C. Severe headache and vomiting
• D. Loss of sensation in the affected limb

Correct answer: A

Rationale: The correct answer is A: Gradual loss of function on one side of the body. In a thrombotic stroke, a blood clot forms in an artery supplying blood to the brain, leading to reduced blood flow to a specific area of the brain. This results in a gradual onset of neurological deficits, such as weakness, numbness, or paralysis on one side of the body. Choices B, C, and D are incorrect because sudden loss of consciousness, severe headache and vomiting, and loss of sensation in the affected limb are more commonly associated with other types of strokes or medical conditions, not specifically thrombotic strokes. Thrombotic strokes typically present with gradual symptoms due to the gradual blockage of blood flow, leading to a progressive neurological deficit.

5. A client with heart failure is prescribed furosemide 20 mg PO twice daily. Which of the following instructions should the nurse include during discharge teaching?

• A. Monitor for increased blood pressure
• B. Increase intake of high-potassium foods
• C. Expect an increase in swelling in the hands and feet
• D. Take the second dose at bedtime

Correct answer: B

Rationale: The correct answer is to instruct the client to increase their intake of high-potassium foods. Furosemide can lead to hypokalemia, a condition of low potassium levels in the blood. Increasing the consumption of high-potassium foods helps prevent this adverse effect. Monitoring for increased blood pressure (choice A) is not directly related to furosemide use. Expecting an increase in swelling (choice C) is incorrect as furosemide is a diuretic that helps reduce swelling. Taking the second dose at bedtime (choice D) is not necessary unless prescribed by the healthcare provider.

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