Nursing Elites

1. A nurse is reviewing the results of an arterial blood gas analysis of a client who has chronic obstructive pulmonary disease. Which of the following results should the nurse expect?

• A. PaO2 of 95 mm Hg
• B. PaCO2 of 55 mm Hg
• C. HCO3 of 24 mEq/L
• D. pH level of 7.35

Correct answer: B

Rationale: In chronic obstructive pulmonary disease, there is impaired gas exchange, leading to retention of carbon dioxide (CO2) and subsequent respiratory acidosis. A PaCO2 of 55 mm Hg is higher than the normal range (35-45 mm Hg) and is indicative of respiratory acidosis in COPD. Choices A, C, and D are not typically associated with COPD. PaO2 may be decreased, HCO3 may be elevated to compensate for acidosis, and pH may be lower than 7.35 due to respiratory acidosis in COPD.

2. Which electrolyte imbalance is common in patients receiving diuretics?

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

Correct answer: A

Rationale: The correct answer is Hypokalemia. Diuretics, such as furosemide, commonly cause potassium loss in patients, leading to hypokalemia. This electrolyte imbalance should be closely monitored to prevent complications like cardiac arrhythmias. Hypercalcemia (Choice B) is not typically associated with diuretic use. Hyponatremia (Choice C) involves low sodium levels and can occur in conditions like syndrome of inappropriate antidiuretic hormone secretion (SIADH) but is not directly caused by diuretics. Hypermagnesemia (Choice D) is an excess of magnesium, usually not a common electrolyte imbalance induced by diuretics.

3. A healthcare provider is caring for a client who has asthma and is experiencing wheezing. Which of the following medications should the healthcare provider administer?

• A. Fluticasone
• B. Montelukast
• C. Albuterol
• D. Ipratropium

Correct answer: C

Rationale: Albuterol is a short-acting beta-agonist bronchodilator used to quickly relieve bronchospasm in clients with asthma who are experiencing wheezing. Fluticasone is an inhaled corticosteroid used for long-term control of asthma symptoms and not for acute wheezing. Montelukast is a leukotriene receptor antagonist used for long-term asthma management, not for immediate relief of wheezing. Ipratropium is an anticholinergic bronchodilator used for chronic obstructive pulmonary disease (COPD) and not typically used as the first-line treatment for asthma exacerbation.

4. What is a crucial nursing responsibility when caring for a patient with a central line?

• A. Flush the line with saline
• B. Monitor for infection
• C. Monitor fluid balance
• D. Replace the central line

Correct answer: B

Rationale: When caring for a patient with a central line, monitoring for infection is a crucial nursing responsibility. This is essential to prevent complications such as bloodstream infections. While flushing the line with saline and monitoring fluid balance are important aspects of care, they are not as critical as monitoring for infection. Replacing the central line is only done when necessary due to complications or at the end of its recommended use.

5. A client with a new prescription for levothyroxine is receiving discharge teaching. Which of the following client statements indicates an understanding of the teaching?

• A. I should take this medication with food to prevent nausea.
• B. I will take this medication every morning before breakfast.
• C. I will stop taking this medication if I experience chest pain.
• D. I will take this medication at bedtime.

Correct answer: B

Rationale: The correct answer is B. Levothyroxine should be taken every morning before breakfast to enhance absorption and maintain consistent thyroid hormone levels. Option A is incorrect because levothyroxine should be taken on an empty stomach. Option C is incorrect because chest pain is not a common side effect of levothyroxine and stopping the medication abruptly can be harmful. Option D is incorrect because taking levothyroxine at bedtime may result in decreased absorption due to interactions with food and other medications.

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