Nursing Elites

1. A nurse is caring for an infant who has coarctation of the aorta. Which of the following should the nurse identify as an expected finding?

• A. Weak femoral pulses.
• B. Frequent nosebleeds.
• C. Upper extremity hypotension.
• D. Increased intracranial pressure.

Correct answer: A

Rationale: Corrected Rationale: Weak femoral pulses are an expected finding in an infant with coarctation of the aorta. The narrowing of the aorta leads to decreased blood flow to the lower extremities, resulting in weak or absent femoral pulses. Frequent nosebleeds (Choice B) are not typically associated with coarctation of the aorta. Upper extremity hypotension (Choice C) is not a common finding in coarctation of the aorta; instead, blood pressure is usually elevated in the upper extremities. Increased intracranial pressure (Choice D) is not directly related to coarctation of the aorta.

2. A nurse is caring for a client who is postoperative following a craniotomy. Which of the following findings indicates the client is developing diabetes insipidus?

• A. Polyuria
• B. Hypertension
• C. Bradycardia
• D. Hyperglycemia

Correct answer: A

Rationale: Polyuria is the correct finding indicating the client is developing diabetes insipidus. Diabetes insipidus is characterized by the excretion of large volumes of diluted urine due to a deficiency in antidiuretic hormone. This results in increased urine output (polyuria) despite adequate fluid intake. Hypertension (choice B) is not typically associated with diabetes insipidus but can be seen in other conditions. Bradycardia (choice C) and hyperglycemia (choice D) are also not typical findings of diabetes insipidus.

3. A nurse is teaching a client who has a new prescription for lisinopril. Which of the following statements should the nurse include?

• A. You should expect to develop a dry cough while taking this medication.
• B. This medication can cause a slow heart rate.
• C. You should increase your intake of foods high in potassium.
• D. You should avoid using salt substitutes while taking this medication.

Correct answer: D

Rationale: The correct statement to include when teaching a client prescribed with lisinopril is that they should avoid using salt substitutes while taking this medication. Lisinopril can cause hyperkalemia, which is an elevated level of potassium in the blood. Therefore, using salt substitutes that contain potassium can worsen this condition. Choices A, B, and C are incorrect because lisinopril is not typically associated with causing a dry cough or a slow heart rate, and increasing potassium intake can be harmful in the presence of lisinopril-induced hyperkalemia.

4. A client is recovering from an acute myocardial infarction that occurred 3 days ago. Which of the following instructions should the nurse include?

• A. Perform an ECG every 12 hours
• B. Place the client in a supine position while resting
• C. Draw a troponin level every 4 hours
• D. Obtain a cardiac rehabilitation consultation

Correct answer: D

Rationale: After an acute myocardial infarction, it is important to involve the client in cardiac rehabilitation to help them recover and manage their condition effectively. Performing an ECG every 12 hours is not necessary unless there are specific indications for it. Placing the client in a supine position may not be ideal as it can increase venous return, potentially worsening cardiac workload. Drawing troponin levels every 4 hours is excessive and not recommended as troponin levels usually peak within 24-48 hours post-MI and then gradually decline.

5. Which of the following is the most concerning electrolyte imbalance for a patient on furosemide?

• A. Hypokalemia
• B. Hyperkalemia
• C. Hyponatremia
• D. Hypercalcemia

Correct answer: A

Rationale: The correct answer is Hypokalemia. Furosemide, a loop diuretic, can lead to potassium depletion in the body, causing hypokalemia. This is a significant concern as low potassium levels can result in cardiac arrhythmias and other serious complications. Hyperkalemia (Choice B) is unlikely to occur as a result of furosemide use. Hyponatremia (Choice C) is more commonly associated with thiazide diuretics. Hypercalcemia (Choice D) is not typically linked to furosemide use.

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