Nursing Elites

1. A nurse is caring for a client who has chronic kidney disease and reports nausea. The nurse should identify that this client is at risk for which of the following imbalances?

• A. Metabolic alkalosis
• B. Metabolic acidosis
• C. Respiratory alkalosis
• D. Respiratory acidosis

Correct answer: B

Rationale: The correct answer is B: Metabolic acidosis. Clients with chronic kidney disease are at risk for metabolic acidosis because the kidneys are unable to effectively excrete acids, leading to an accumulation of acid in the body. This metabolic imbalance can result in symptoms like nausea. Choices A, C, and D are incorrect. Metabolic alkalosis is not typically associated with chronic kidney disease. Respiratory alkalosis is more commonly seen in conditions such as hyperventilation. Respiratory acidosis, on the other hand, is often linked to conditions affecting the lungs or respiratory system, not primarily kidney disease.

2. How should fluid overload in a patient with heart failure be managed?

• A. Administer diuretics
• B. Increase fluid intake
• C. Provide oral fluids
• D. Provide chest physiotherapy

Correct answer: A

Rationale: Administering diuretics is the appropriate management for fluid overload in a patient with heart failure. Diuretics help to reduce fluid retention by increasing urine output, thereby alleviating the fluid overload. Choices B, C, and D are incorrect. Increasing fluid intake would worsen the condition by adding more fluid to an already overloaded system. Providing oral fluids is not specific enough to address the excess fluid in the body, and chest physiotherapy is not indicated for managing fluid overload in heart failure patients.

3. A client has a new prescription for metoprolol. Which of the following client statements indicates an understanding of the teaching?

• A. I will take this medication with a glass of milk.
• B. I will take my pulse before taking this medication.
• C. I will stop taking this medication if I experience nausea.
• D. I will take an antacid with this medication.

Correct answer: B

Rationale: The correct answer is B. Clients taking metoprolol should regularly check their pulse and should not take the medication if their pulse is too low. Option A is incorrect because metoprolol should not be taken with a glass of milk. Option C is incorrect because stopping medication abruptly can be harmful. Option D is incorrect because antacids should not be taken with metoprolol as they can decrease its absorption.

4. What is the best intervention for a patient with suspected deep vein thrombosis (DVT)?

• A. Administer anticoagulants
• B. Apply compression stockings
• C. Encourage ambulation
• D. Monitor oxygen saturation

Correct answer: A

Rationale: The best intervention for a patient with suspected deep vein thrombosis (DVT) is to administer anticoagulants. Anticoagulants help prevent further clot formation and reduce the risk of complications such as pulmonary embolism. Applying compression stockings can help manage symptoms but does not address the underlying issue of clot formation. Encouraging ambulation is beneficial for overall circulation but may not be sufficient to treat DVT. Monitoring oxygen saturation is important, but it is not the primary intervention for suspected DVT.

5. A nurse is caring for a client who is receiving TPN. Which of the following actions should the nurse take to prevent infection?

• A. Change the TPN tubing every 72 hours.
• B. Monitor the client's blood glucose every 4 hours.
• C. Monitor the client's urine output every 8 hours.
• D. Use sterile technique when changing the central line dressing.

Correct answer: D

Rationale: The correct answer is D: 'Use sterile technique when changing the central line dressing.' When caring for a client receiving TPN, it is crucial to maintain aseptic technique to prevent infections. Changing the central line dressing with sterile technique helps reduce the risk of introducing pathogens into the client's system. Choices A, B, and C are incorrect because changing the TPN tubing every 72 hours, monitoring blood glucose, and monitoring urine output are important aspects of care but are not directly related to preventing infection in clients receiving TPN.

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