Nursing Elites

1. A nurse is assigned to care for a group of clients. On reviewing the clients' medical records, the nurse determines that which client is at risk for deficient fluid volume?

• A. A client with a colostomy
• B. A client with congestive heart failure
• C. A client with decreased kidney function
• D. A client receiving frequent wound irrigations

Correct answer: A

Rationale: The correct answer is A. Clients with a colostomy are at risk for deficient fluid volume due to the loss of fluid through the colostomy. In colostomy, there can be increased fluid loss through the stoma, which may lead to dehydration and electrolyte imbalances. Choices B, C, and D do not directly relate to the risk for deficient fluid volume. Clients with congestive heart failure are more prone to fluid overload rather than deficient volume. Clients with decreased kidney function are at risk for fluid retention, not deficient volume. Clients receiving frequent wound irrigations may be at risk for infection, but this does not directly indicate deficient fluid volume.

2. What is the approximate duration of action for intermediate-acting insulins like NPH?

• A. 6-8 hours.
• B. 10-14 hours.
• C. 16-20 hours.
• D. 24-28 hours.

Correct answer: C

Rationale: The correct answer is C: '16-20 hours.' Intermediate-acting insulins like NPH typically have a duration of action of approximately 16-20 hours. This prolonged action makes them effective in managing blood glucose levels over an extended period. Choices A, B, and D are incorrect because they do not align with the typical duration of action for intermediate-acting insulins. Choice A (6-8 hours) is too short, choice B (10-14 hours) is also shorter than the typical duration, and choice D (24-28 hours) is too long for intermediate-acting insulins like NPH.

3. A healthcare provider caring for a client with severe malnutrition reviews the laboratory results and notes a magnesium level of 1.0 mg/dL. Which electrocardiographic change would the healthcare provider expect to note based on the magnesium level?

• A. Prominent U waves
• B. Prolonged PR interval
• C. Depressed ST segment
• D. Widened QRS complexes

Correct answer: C

Rationale: A magnesium level of 1.0 mg/dL can cause a depressed ST segment on the ECG. Magnesium deficiency commonly leads to ST segment depression on an electrocardiogram. Prominent U waves are associated with hypokalemia, prolonged PR interval is seen in conditions like first-degree heart block, and widened QRS complexes are typically related to conditions affecting the conduction system of the heart, such as bundle branch blocks.

4. A healthcare professional is preparing to care for a client with a potassium deficit. The healthcare professional reviews the client's record and determines that the client was at risk for developing the potassium deficit because the client:

• A. Has renal failure.
• B. Requires nasogastric suction.
• C. Has a history of Addison's disease.
• D. Is taking a potassium-sparing diuretic.

Correct answer: B

Rationale: Nasogastric suction can lead to significant potassium loss due to the continuous drainage of gastric contents, increasing the risk of a potassium deficit. Choices A, C, and D do not directly result in the significant loss of potassium. Renal failure may lead to potassium retention rather than a deficit. Addison's disease is associated with adrenal insufficiency, not potassium depletion. Potassium-sparing diuretics, as the name suggests, typically help retain potassium rather than cause a deficit.

5. The client with type 2 diabetes mellitus is being educated about lifestyle modifications. Which of the following recommendations is appropriate?

• A. Avoiding all forms of physical exercise
• B. Limiting carbohydrate intake to less than 30 grams per day
• C. Increasing physical activity to help control blood glucose levels
• D. Consuming a high-protein, low-fat diet

Correct answer: C

Rationale: The correct answer is to increase physical activity to help control blood glucose levels. Physical activity is essential in managing type 2 diabetes mellitus as it helps improve insulin sensitivity, control weight, and regulate blood sugar levels. Avoiding all forms of physical exercise (Choice A) is incorrect as exercise plays a crucial role in diabetes management. While limiting carbohydrate intake (Choice B) can be beneficial, setting a strict limit of less than 30 grams per day is too restrictive and may not be suitable for everyone. Consuming a high-protein, low-fat diet (Choice D) is generally a healthy choice, but it is not the primary lifestyle modification recommended for managing type 2 diabetes mellitus.

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