Nursing Elites

1. What does continuous bubbling in the water seal chamber of a chest tube indicate?

• A. An air leak
• B. A blocked chest tube
• C. Normal chest tube function
• D. Continuous drainage from the chest tube

Correct answer: A

Rationale: Continuous bubbling in the water seal chamber of a chest tube indicates an air leak in the system. This occurs when air is entering the system through a leak, preventing the lung from fully re-expanding. Choice B, a blocked chest tube, is incorrect as a blocked tube would result in a lack of drainage rather than continuous bubbling. Choice C, normal chest tube function, is incorrect as continuous bubbling signifies an issue. Choice D, continuous drainage from the chest tube, is incorrect as bubbling in the water seal chamber specifically indicates an air leak, not just the presence of drainage.

2. A nurse is providing dietary teaching for a client who has chronic cholecystitis. Which of the following diets should the nurse recommend?

• A. Low potassium diet
• B. High fiber diet
• C. Low fat diet
• D. Low sodium diet

Correct answer: C

Rationale: The correct answer is C: Low fat diet. A low-fat diet is recommended for clients with chronic cholecystitis to reduce episodes of biliary colic. High-fat foods can trigger symptoms by causing the gallbladder to contract, leading to pain. Choice A, a low potassium diet, is not specifically indicated for chronic cholecystitis. Choice B, a high fiber diet, though generally healthy, may worsen symptoms in some individuals with cholecystitis due to the increased intestinal gas production. Choice D, a low sodium diet, is not directly related to the management of chronic cholecystitis.

3. A nurse is assessing a client who has a heart rate of 40/min. The client is diaphoretic and has chest pain. Which of the following medications should the nurse plan to administer?

• A. Lidocaine
• B. Adenosine
• C. Atropine
• D. Verapamil

Correct answer: C

Rationale: The correct answer is C: Atropine. The client's presentation of bradycardia, diaphoresis, and chest pain indicates reduced cardiac output, requiring intervention to increase the heart rate. Atropine is used to treat bradycardia by blocking cardiac muscarinic receptors, thus inhibiting the parasympathetic nervous system. Lidocaine (Choice A) is used for ventricular arrhythmias, not bradycardia. Adenosine (Choice B) is used for supraventricular tachycardia, not bradycardia. Verapamil (Choice D) is a calcium channel blocker used for certain arrhythmias and hypertension, but not for increasing heart rate in bradycardia.

4. What dietary recommendations should be given to a patient with pre-dialysis end-stage kidney disease?

• A. Reduce phosphorus intake to 700 mg/day
• B. Increase sodium intake
• C. Increase protein intake
• D. Increase potassium intake

Correct answer: A

Rationale: The correct recommendation for a patient with pre-dialysis end-stage kidney disease is to reduce phosphorus intake to 700 mg/day. High phosphorus levels can lead to complications in such patients. Increasing sodium intake (Choice B) is generally not recommended due to its association with hypertension and fluid retention. While protein is essential, increasing protein intake (Choice C) in kidney disease can be harmful as it can lead to increased waste products that the kidneys may struggle to excrete. Increasing potassium intake (Choice D) is not advisable as well, as patients with kidney disease may already have difficulty excreting potassium, leading to hyperkalemia.

5. A nurse is caring for a client who is receiving total parenteral nutrition (TPN). Which of the following findings should the nurse identify as a possible complication of TPN administration?

• A. Pitting edema of bilateral lower extremities
• B. Hypoactive bowel sounds in all four quadrants
• C. Weight is the same as the day before
• D. Bilateral posterior lung sounds are diminished

Correct answer: A

Rationale: The correct answer is A: Pitting edema of bilateral lower extremities. Pitting edema can indicate fluid overload, which is a potential complication of TPN administration. Choice B, hypoactive bowel sounds, is more indicative of a gastrointestinal issue rather than a complication of TPN. Choice C, weight remaining the same, is expected to remain stable with proper TPN administration. Choice D, diminished lung sounds, is not directly related to TPN administration and is more suggestive of a respiratory issue.

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