Nursing Elites

1. A healthcare professional reviews a client's electrolyte laboratory report and notes that the potassium level is 3.2 mEq/L. Which of the following would the healthcare professional note on the electrocardiogram as a result of the laboratory value?

• A. U waves
• B. Absent P waves
• C. Elevated T waves
• D. Elevated ST segment

Correct answer: A

Rationale: The correct answer is A: U waves. A low potassium level (hypokalemia) can manifest as U waves on an ECG. U waves are small, extra deflections seen after the T wave and may indicate cardiac irritability. Absent P waves (Choice B) are associated with conditions like atrial fibrillation. Elevated T waves (Choice C) can be seen in hyperkalemia, not hypokalemia. Elevated ST segment (Choice D) is not typically associated with low potassium levels but can be seen in conditions like myocardial infarction.

2. What is the mechanism of action of corticotropin (Acthar) when prescribed as replacement therapy for a male client who has undergone surgical removal of a pituitary tumor?

• A. It decreases cyclic adenosine monophosphate (cAMP) production and affects the metabolic rate of target organs.
• B. It interacts with plasma membrane receptors to inhibit enzymatic actions.
• C. It interacts with plasma membrane receptors to produce enzymatic actions that affect protein, fat, and carbohydrate metabolism.
• D. It regulates the threshold for water reabsorption in the kidneys.

Correct answer: C

Rationale: Corticotropin (ACTH) stimulates the adrenal cortex to secrete cortisol and other hormones, affecting protein, fat, and carbohydrate metabolism. Choice A is incorrect because corticotropin does not decrease cAMP production; instead, it stimulates enzymatic actions. Choice B is incorrect because corticotropin does not inhibit enzymatic actions but rather produces enzymatic actions. Choice D is incorrect because corticotropin's mechanism of action does not involve regulating the threshold for water reabsorption in the kidneys.

3. The nurse is caring for a client with primary adrenal insufficiency (Addison's disease). Which of the following laboratory findings would the nurse expect?

• A. Hypernatremia
• B. Hyperkalemia
• C. Hyperglycemia
• D. Hypercalcemia

Correct answer: B

Rationale: In primary adrenal insufficiency (Addison's disease), there is a decrease in aldosterone levels, leading to sodium loss and potassium retention. This imbalance results in hyperkalemia, making choice B the correct answer. Hypernatremia (choice A) is unlikely due to sodium loss. Hyperglycemia (choice C) and hypercalcemia (choice D) are not typically associated with primary adrenal insufficiency.

4. What is the lowest fasting plasma glucose level suggestive of a diagnosis of DM?

• A. 90 mg/dl.
• B. 115 mg/dl.
• C. 126 mg/dl.
• D. 180 mg/dl.

Correct answer: C

Rationale: A fasting plasma glucose level of 126 mg/dl or higher is diagnostic of diabetes mellitus. Choice A (90 mg/dl) is too low to indicate diabetes. Choice B (115 mg/dl) is also below the diagnostic threshold for diabetes. Choice D (180 mg/dl) is above the diagnostic threshold and would indicate uncontrolled diabetes, not the lowest level suggestive of a diagnosis.

5. A healthcare professional is preparing to care for a client with a potassium deficit. The healthcare professional reviews the client's record and determines that the client was at risk for developing the potassium deficit because the client:

• A. Has renal failure.
• B. Requires nasogastric suction.
• C. Has a history of Addison's disease.
• D. Is taking a potassium-sparing diuretic.

Correct answer: B

Rationale: Nasogastric suction can lead to significant potassium loss due to the continuous drainage of gastric contents, increasing the risk of a potassium deficit. Choices A, C, and D do not directly result in the significant loss of potassium. Renal failure may lead to potassium retention rather than a deficit. Addison's disease is associated with adrenal insufficiency, not potassium depletion. Potassium-sparing diuretics, as the name suggests, typically help retain potassium rather than cause a deficit.

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