Nursing Elites

1. A nurse is taking care of a 65-year-old female patient in a medical-surgical unit who is in renal failure; during the assessment, the patient complains of tingling in her lips and fingers. When the nurse takes her blood pressure, she has a spasm in her wrist and hand. The nurse suspects:

• A. Hypophosphatemia
• B. Hypocalcemia
• C. Hypermagnesemia
• D. Hyperkalemia

Correct answer: B

Rationale: The patient's symptoms of tingling in the lips and fingers along with the wrist and hand spasm are indicative of tetany, a characteristic manifestation of hypocalcemia. Hypocalcemia and hypomagnesemia can present with sensations of tingling in the extremities and around the mouth. The spasm in the wrist and hand when taking blood pressure could be due to slight ischemia of the ulnar nerve, further supporting the suspicion of hypocalcemia in this patient. Hypophosphatemia, hypermagnesemia, and hyperkalemia do not typically present with these specific symptoms and manifestations.

2. You are performing an admission assessment on an older adult patient newly admitted for end-stage liver disease. What principle should guide your assessment of the patients skin turgor?

• A. Overhydration is common among healthy older adults.
• B. Dehydration causes the skin to appear spongy
• C. Inelastic skin turgor is a normal part of aging
• D. Skin turgor cannot be assessed in patients over 70.

Correct answer: C

Rationale:

3. A nurse sees a variety of patients in the community health clinic. Which of the following patients would be at the greatest risk of dehydration?

• A. An 18-year-old basketball player with a stress fracture of the right foot
• B. An infant with diarrhea
• C. A 45-year-old with stomach flu
• D. An elderly patient living alone

Correct answer: B

Rationale: The correct answer is B. Infants are particularly vulnerable to dehydration due to diarrhea because they have a higher fluid turnover and less reserve. Option A, the 18-year-old basketball player with a stress fracture, is less likely to be at the greatest risk of dehydration compared to an infant with diarrhea. Option C, the 45-year-old with stomach flu, may experience dehydration but is not at the same level of risk as an infant with diarrhea. Option D, the elderly patient living alone, could be at risk of dehydration, but infants with diarrhea are at the greatest risk due to their unique physiological characteristics.

4. A newly graduated nurse is admitting a patient with a long history of emphysema. The new nurses preceptor is going over the patients past lab reports with the new nurse. The nurse takes note that the patients PaCO2 has been between 56 and 64 mm Hg for several months. The preceptor asks the new nurse why they will be cautious administering oxygen. What is the new nurses best response?

• A. The patients calcium will rise dramatically due to pituitary stimulation.
• B. Oxygen will increase the patients intracranial pressure and create confusion.
• C. Oxygen may cause the patient to hyperventilate and become acidotic.
• D. Using oxygen may result in the patient developing carbon dioxide narcosis and hypoxemia.

Correct answer: D

Rationale:

5. After providing discharge teaching, a nurse assesses the clients understanding regarding increased risk for metabolic alkalosis. Which statement indicates the client needs additional teaching?

• A. . I dont drink milk because it gives me gas and diarrhea
• B. I have been taking digoxin every day for the last 15 years
• C. . I take sodium bicarbonate after every meal to prevent heartburn
• D. In hot weather, I sweat so much that I drink six glasses of water each day.

Correct answer: C

Rationale:

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