Nursing Elites

1. A patient with ventricular tachycardia and a pulse needs electrical intervention. What is the appropriate action?

• A. Defibrillation
• B. Synchronized cardioversion
• C. Pacing
• D. Medication administration

Correct answer: B

Rationale: For a patient with ventricular tachycardia and a pulse, the appropriate action is synchronized cardioversion. Defibrillation is used for pulseless ventricular tachycardia or ventricular fibrillation. Pacing is typically used for bradycardias. Medication administration may be considered in stable ventricular tachycardia cases but electrical intervention is preferred for immediate correction in this scenario.

2. A patient is receiving discharge instructions for GERD. Which of the following statements by the patient demonstrates an understanding of the teaching?

• A. I should take my medication with orange juice.
• B. Having a bedtime snack will prevent heartburn.
• C. I will lie down after meals.
• D. I will limit activities that require bending at the waist.

Correct answer: D

Rationale: The correct answer is D. Patients with GERD should avoid activities that increase intra-abdominal pressure, such as bending at the waist, as this can lead to reflux. Choice A is incorrect because medications for GERD are usually taken with water, not citrus juices. Choice B is incorrect as having a bedtime snack can worsen GERD symptoms. Choice C is incorrect because lying down after meals can also exacerbate reflux due to the effects of gravity.

3. What adverse effect might occur in a patient receiving radiation after a mastectomy?

• A. Seizures
• B. JVD and fatigue
• C. SOB and JVD
• D. S3 heart sound

Correct answer: D

Rationale: The correct adverse effect that might occur in a patient receiving radiation after a mastectomy is the development of an S3 heart sound. This can result from decreased pumping ability following mastectomy and radiation treatment. Choice A, seizures, is incorrect as seizures are not a common adverse effect of radiation after a mastectomy. Choice B, JVD and fatigue, is incorrect as while fatigue can be a common side effect, JVD (Jugular Venous Distention) is not typically associated with radiation after a mastectomy. Choice C, SOB (Shortness of Breath) and JVD, is incorrect as while shortness of breath can occur, JVD is not a typical adverse effect of radiation post-mastectomy.

4. What are the adverse effects of radiation after a mastectomy?

• A. S3 heart sound, fatigue
• B. Pulselessness in the affected extremity
• C. SOB and JVD
• D. Localized pain, swelling, erythema

Correct answer: A

Rationale: The correct answer is A: S3 heart sound, fatigue. Radiation after a mastectomy can lead to fatigue and symptoms of heart failure, such as the presence of an S3 heart sound. Choices B, C, and D are incorrect. Pulselessness in the affected extremity would be more relevant to vascular complications, shortness of breath (SOB) and jugular venous distention (JVD) could indicate cardiac or respiratory issues unrelated to radiation, and localized pain, swelling, and erythema are more characteristic of a local inflammatory response rather than the systemic effects of radiation post-mastectomy.

5. A patient diagnosed with hypokalemia is at risk for which condition?

• A. Cardiac dysrhythmias
• B. Muscle weakness
• C. Seizures
• D. Bradycardia

Correct answer: A

Rationale: Patients diagnosed with hypokalemia are at risk for cardiac dysrhythmias due to low potassium levels. Hypokalemia can lead to abnormalities in the electrical conduction system of the heart, potentially causing irregular heart rhythms. Muscle weakness (Choice B) is a symptom commonly associated with hypokalemia, but the question asks about conditions the patient is at risk for, not specific symptoms. Seizures (Choice C) are not typically associated with hypokalemia; they are more commonly linked with conditions such as epilepsy. Bradycardia (Choice D) refers to a slow heart rate, which is not a typical risk associated with hypokalemia; instead, tachycardia (fast heart rate) is more commonly observed in patients with low potassium levels.

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