Nursing Elites

1. A nurse is caring for a client who has Cushing's syndrome. Which of the following findings should the nurse expect?

• A. Hypotension.
• B. Weight loss.
• C. Hyperkalemia.
• D. Hypercalcemia.

Correct answer: C

Rationale: In clients with Cushing's syndrome, the nurse should expect hyperkalemia. Cushing's syndrome is characterized by excess cortisol levels, which can lead to potassium retention and result in hyperkalemia. Choices A, B, and D are incorrect. Hypotension is not typically associated with Cushing's syndrome; instead, hypertension is more common due to the effects of cortisol. Weight gain, rather than weight loss, is a common symptom of Cushing's syndrome. Hypercalcemia is not a typical finding in Cushing's syndrome; instead, hypocalcemia may occur due to increased urinary calcium excretion.

2. A nurse is providing discharge teaching to a client who has a wound infection. Which of the following information should the nurse include about home care?

• A. Soak the wound in warm water every day
• B. Use hydrogen peroxide to clean the wound
• C. Apply a cold compress to the wound
• D. Keep the wound covered with a dry dressing

Correct answer: D

Rationale: The correct answer is D: 'Keep the wound covered with a dry dressing.' When providing care for a wound infection, it is essential to keep the wound covered with a dry dressing to prevent further contamination and promote healing. Soaking the wound in warm water (choice A) can introduce moisture and increase the risk of infection. Using hydrogen peroxide (choice B) can be too harsh and may slow down the healing process by damaging healthy tissue. Applying a cold compress (choice C) is not typically recommended for wound infections, as it may not provide the necessary environment for healing.

3. A healthcare professional is reviewing the medical record of a client who has a new prescription for ceftriaxone. The healthcare professional should identify which of the following findings as a contraindication to this medication?

• A. Seizure disorder
• B. Hypertension
• C. Penicillin allergy
• D. Hyperlipidemia

Correct answer: C

Rationale: The correct answer is C: Penicillin allergy. Penicillin allergy is a contraindication for ceftriaxone because both medications are beta-lactam antibiotics. Seizure disorder (choice A), hypertension (choice B), and hyperlipidemia (choice D) are not contraindications for ceftriaxone and do not directly affect the use of this antibiotic.

4. What is the priority intervention for a patient with a severe allergic reaction?

• A. Administer epinephrine
• B. Administer corticosteroids
• C. Administer oxygen
• D. Administer antihistamines

Correct answer: A

Rationale: The correct answer is to administer epinephrine. Epinephrine is the first-line treatment for severe allergic reactions because it rapidly reverses the symptoms of anaphylaxis by constricting blood vessels, increasing heart rate, and relaxing airway muscles. Corticosteroids, although helpful to reduce inflammation, are not the priority in the acute management of severe allergic reactions. Oxygen may be needed to support breathing, but it is not the initial priority. Antihistamines are not as effective as epinephrine in treating severe allergic reactions and should not be the first intervention.

5. A nurse is caring for a client who has depression and reports taking St. John's Wort along with citalopram. The nurse should monitor the client for which condition as a result of an interaction between these substances?

• A. Tardive dyskinesia.
• B. Serotonin syndrome.
• C. Pseudoparkinsonism.
• D. Acute dystonia.

Correct answer: B

Rationale: The correct answer is B: Serotonin syndrome. Serotonin syndrome can occur due to the interaction between citalopram, an SSRI, and St. John's Wort, an herbal supplement. Symptoms of serotonin syndrome include confusion, agitation, rapid heart rate, high blood pressure, dilated pupils, loss of muscle coordination, and sweating. Choices A, C, and D are incorrect as they are not typically associated with the interaction between citalopram and St. John's Wort. Tardive dyskinesia is a movement disorder associated with long-term use of certain medications, pseudoparkinsonism is a side effect of certain antipsychotic medications, and acute dystonia is a movement disorder caused by certain medications like antipsychotics.

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