Nursing Elites

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

• A. An air leak
• B. Normal chest tube function
• C. A blockage in the chest tube
• D. A malfunction in the drainage system

Correct answer: A

Rationale: Continuous bubbling in the water seal chamber of a chest tube indicates an air leak. This bubbling occurs when air leaks from the patient's pleural space into the chest tube system. It is essential to address this issue promptly to prevent complications like a pneumothorax. Choices B, C, and D are incorrect because continuous bubbling in the water seal chamber is not indicative of normal chest tube function, a blockage in the chest tube, or a malfunction in the drainage system.

2. A nurse is caring for a client who is hyperventilating and has the following ABG results: pH 7.50, PaCO2 29 mm Hg, and HCO3- 25 mEq/L. The nurse should recognize that the client has which of the following acid-base imbalances?

• A. Respiratory acidosis
• B. Respiratory alkalosis
• C. Metabolic acidosis
• D. Metabolic alkalosis

Correct answer: B

Rationale: The correct answer is B: Respiratory alkalosis. In this scenario, the client is experiencing respiratory alkalosis due to hyperventilation. Hyperventilation leads to excessive loss of carbon dioxide, causing a decrease in hydrogen ion concentration and an increase in pH levels. Choices A, C, and D are incorrect. Respiratory acidosis is characterized by high PaCO2 and low pH. Metabolic acidosis is associated with low HCO3- levels and low pH. Metabolic alkalosis is marked by high HCO3- levels and high pH. In this case, the ABG results indicate respiratory alkalosis.

3. 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.

4. What are the expected findings in a patient experiencing hypokalemia?

• A. Flattened T waves on an ECG
• B. Elevated ST segments
• C. Prominent U waves
• D. Bradycardia

Correct answer: A

Rationale: The correct answer is A: Flattened T waves on an ECG. Hypokalemia is characterized by flattened T waves on an ECG, which is an early indicator of low potassium levels. Elevated ST segments (Choice B) are associated with conditions like myocardial infarction, not hypokalemia. Prominent U waves (Choice C) are typically seen in hypokalemia, but flattened T waves are more specific. Bradycardia (Choice D) can be a manifestation of severe hypokalemia but is not as specific as flattened T waves on an ECG.

5. What is the first medication to give to a patient with an allergic reaction causing wheezing?

• A. Albuterol 3 ml via nebulizer
• B. Methylprednisolone 100 mg IV
• C. Cromolyn 20 mg via nebulizer
• D. Aminophylline 500 mg IV

Correct answer: A

Rationale: The correct answer is A, Albuterol 3 ml via nebulizer. Albuterol is a fast-acting bronchodilator that helps relieve wheezing by relaxing the muscles in the airways, making it the first-line treatment for wheezing caused by bronchospasms in allergic reactions. Methylprednisolone (Choice B) is a corticosteroid used for its anti-inflammatory properties and is typically given after bronchodilators. Cromolyn (Choice C) is a mast cell stabilizer that is used for the prevention of asthma symptoms, not for immediate relief. Aminophylline (Choice D) is a bronchodilator that is less commonly used nowadays due to its narrow therapeutic window and potential for toxicity.

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