Nursing Elites

1. A patient with chronic kidney disease may require dietary restrictions. Which of the following diets should the healthcare provider prescribe?

• A. Low sodium diet
• B. Potassium restricted diet
• C. High phosphorus diet
• D. High protein diet

Correct answer: B

Rationale: Patients with chronic kidney disease often require a potassium-restricted diet to help manage their electrolyte levels. Excessive potassium intake can be harmful to individuals with compromised kidney function. While monitoring sodium intake is also important for these patients, a low sodium diet is not specifically indicated in the question. High phosphorus diet and high protein diet are not recommended for individuals with chronic kidney disease as they can further stress the kidneys and worsen the condition.

2. What are the expected symptoms of a thrombotic stroke?

• A. Gradual loss of function on one side of the body
• B. Sudden loss of consciousness
• C. Severe headache and confusion
• 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 clot blocks a cerebral artery, leading to a gradual onset of symptoms such as weakness, numbness, or paralysis on one side of the body. Choice B, 'Sudden loss of consciousness,' is more characteristic of a hemorrhagic stroke. Choice C, 'Severe headache and confusion,' are often associated with subarachnoid hemorrhage rather than thrombotic stroke. Choice D, 'Loss of sensation in the affected limb,' is not a typical symptom pattern for a thrombotic stroke, which usually presents with motor deficits.

3. A nurse is planning care for a group of postoperative clients. Which of the following interventions should the nurse identify as the priority?

• A. Administer IV pain medication to a client who reports pain as a 6 on a scale of 0 to 10
• B. Administer oxygen to a client who has an oxygen saturation of 91%
• C. Instruct a client who is 1 hr postoperative about coughing and deep breathing exercises
• D. Initiate an infusion of 0.9% sodium chloride for a client who has just had abdominal surgery

Correct answer: B

Rationale: The priority intervention is administering oxygen. Postoperatively, the client's oxygen saturation should be at or above 95%. Oxygen is essential for tissue perfusion and cellular oxygenation. While managing pain is important, oxygenation takes precedence. Instructing a client about coughing and deep breathing exercises is important for preventing respiratory complications but is not as urgent as addressing low oxygen saturation. Initiating an infusion of 0.9% sodium chloride is a routine postoperative intervention for fluid balance but is not the priority when oxygen saturation is low.

4. What signs indicate increased intracranial pressure (IICP)?

• A. Restlessness, irritability, and confusion
• B. Sudden onset of seizures
• C. Bradycardia and altered pupil response
• D. Loss of consciousness

Correct answer: A

Rationale: Restlessness, irritability, and confusion are early signs of increased intracranial pressure (IICP). These symptoms occur due to the brain's increased pressure within the skull. Sudden onset of seizures (Choice B) is not typically associated with increased intracranial pressure. Bradycardia and altered pupil response (Choice C) are signs of advanced or worsening IICP. Loss of consciousness (Choice D) is a late sign of increased intracranial pressure.

5. What ECG changes should be monitored in a patient with hypokalemia?

• A. Flattened T waves and prominent U waves
• B. Elevated ST segments and wide QRS complexes
• C. Tall T waves and flattened QRS complexes
• D. Widened QRS complexes and decreased P wave amplitude

Correct answer: A

Rationale: The correct answer is A: Flattened T waves and prominent U waves. In hypokalemia, there is a decrease in potassium levels, which can lead to ECG changes such as flattened T waves and prominent U waves. These changes are classic findings associated with hypokalemia. Choices B (Elevated ST segments and wide QRS complexes), C (Tall T waves and flattened QRS complexes), and D (Widened QRS complexes and decreased P wave amplitude) are all incorrect. Elevated ST segments and wide QRS complexes are not typically seen in hypokalemia. Tall T waves and flattened QRS complexes, as well as widened QRS complexes and decreased P wave amplitude, do not represent the typical ECG changes seen in hypokalemia.

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