Nursing Elites

1. A patient is admitted with a diagnosis of myasthenia gravis. What symptom should the nurse expect to find during the assessment?

• A. Joint pain
• B. Muscle weakness
• C. Loss of sensation
• D. Severe headache

Correct answer: B

Rationale: Myasthenia gravis is a neuromuscular disorder characterized by muscle weakness and fatigue, especially in the voluntary muscles. Patients with myasthenia gravis commonly experience weakness in muscles that control eye movements, facial expressions, chewing, swallowing, and speaking. This weakness typically worsens with activity and improves with rest. Joint pain, loss of sensation, and severe headaches are not typical symptoms of myasthenia gravis. Therefore, the correct answer is muscle weakness (choice B) as it aligns with the characteristic symptom of myasthenia gravis.

2. A patient with Parkinson's disease is prescribed levodopa. What dietary modification should the nurse suggest to the patient?

• A. Increase intake of vitamin C.
• B. Limit foods high in protein.
• C. Avoid foods rich in fiber.
• D. Increase sodium intake.

Correct answer: B

Rationale: The correct answer is to limit foods high in protein. Patients taking levodopa should restrict their intake of protein-rich foods because protein can interfere with the absorption of the medication. Levodopa competes with dietary proteins for absorption in the small intestine, potentially reducing the effectiveness of the medication. Therefore, by reducing protein intake, the patient can enhance the absorption and therapeutic effects of levodopa. Increasing vitamin C intake is not necessary for patients prescribed with levodopa. Avoiding foods rich in fiber or increasing sodium intake are not directly related to optimizing levodopa therapy and might not benefit the patient's condition.

3. The client has acute kidney injury (AKI). Which assessment finding requires immediate intervention?

• A. Urine output of 50 ml in the last hour.
• B. Serum potassium of 6.2 mEq/L.
• C. Blood pressure of 150/90 mm Hg.
• D. Serum creatinine of 2.5 mg/dL.

Correct answer: B

Rationale: An elevated serum potassium level of 6.2 mEq/L in a client with AKI can lead to life-threatening cardiac arrhythmias, necessitating immediate intervention. Hyperkalemia is a serious complication in AKI as impaired kidney function can result in the accumulation of potassium in the blood, posing a risk of cardiac arrest. Prompt treatment to lower potassium levels is crucial to prevent cardiac complications in this situation.

4. A patient who is diagnosed with cervical cancer that is classified as Tis, N0, M0 asks the nurse what the letters and numbers mean. Which response by the nurse is most appropriate?

• A. The cancer involves only the cervix.
• B. The cancer cells closely resemble normal cells.
• C. Further testing is necessary to determine the spread of the cancer.
• D. Determining the original site of the cervical cancer is challenging.

Correct answer: A

Rationale: The correct response is A: 'The cancer involves only the cervix.' In staging, 'Tis' indicates cancer in situ, which means it is localized to the cervix and not invasive at this time. The differentiation of cancer cells is not part of clinical staging. Since the cancer is in situ, its origin is the cervix. Further testing is not required as the cancer has not spread beyond the cervix. Choice B is incorrect as the staging information provided does not relate to the resemblance of cancer cells to normal cells. Choice C is incorrect because further testing is not necessary as the cancer is localized. Choice D is incorrect because the staging information provided clearly indicates the site of origin as the cervix.

5. The healthcare provider prescribes 15 mg/kg of Streptomycin for an infant weighing 4 pounds. The drug is diluted in 25 ml of D5W to run over 8 hours. How much Streptomycin will the infant receive?

• A. 9 mg
• B. 18 mg
• C. 27 mg
• D. 36 mg

Correct answer: A

Rationale: To calculate the dosage, first, convert the weight from pounds to kg (4 lbs / 2.2 ≈ 1.82 kg). Then, multiply by the prescribed mg/kg (15 mg/kg * 1.82 kg ≈ 27.3 mg). However, since the question asks for the closest correct option, the infant will receive approximately 9 mg.

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