Nursing Elites

1. A physician suspects a patient may have pancreatitis. Which of the following tests would be most appropriate to diagnose this condition?

• A. CK and Troponin
• B. BUN and Creatinine
• C. Amylase and Lipase
• D. HDL and LDL Cholesterol Levels

Correct answer: C

Rationale: To diagnose pancreatitis, testing amylase and lipase levels is crucial. Amylase and lipase are enzymes produced by the pancreas that help digest carbohydrates and lipids. In pancreatitis, these enzymes are released in high amounts into the bloodstream due to pancreatic inflammation or damage. Elevated levels of amylase and lipase in blood tests strongly indicate pancreatitis. Choice A, CK and Troponin, are cardiac markers used in diagnosing heart conditions like myocardial infarction, not pancreatitis. Choice B, BUN and Creatinine, are kidney function tests, not specific to pancreatitis. Choice D, HDL and LDL Cholesterol Levels, are lipid profile tests used to assess cardiovascular health, not for diagnosing pancreatitis.

2. A patient with a history of diabetes mellitus is on the second postoperative day following cholecystectomy. She has complained of nausea and isn't able to eat solid foods. The nurse enters the room to find the patient confused and shaky. Which of the following is the most likely explanation for the patient's symptoms?

• A. Anesthesia reaction
• B. Hyperglycemia
• C. Hypoglycemia
• D. Diabetic ketoacidosis

Correct answer: C

Rationale: In a postoperative diabetic patient who is unable to eat solid foods, the likely cause of symptoms such as confusion and shakiness is hypoglycemia. Confusion and shakiness are common manifestations of hypoglycemia. Insufficient glucose supply to the brain (neuroglycopenia) can lead to confusion, difficulty with concentration, irritability, hallucinations, focal impairments like hemiplegia, and, in severe cases, coma and death. Anesthesia reaction (Choice A) is less likely in this scenario as the patient is already on the second postoperative day. Hyperglycemia (Choice B) is unlikely given the patient's symptoms and history of not eating. Diabetic ketoacidosis (Choice D) typically presents with hyperglycemia, ketosis, and metabolic acidosis, which are not consistent with the patient's current symptoms of confusion and shakiness.

3. A nurse is caring for an infant who has recently been diagnosed with a congenital heart defect. Which of the following clinical signs would most likely be present?

• A. Slow pulse rate
• B. Weight gain
• C. Decreased systolic pressure
• D. Irregular WBC lab values

Correct answer: B

Rationale: Weight gain due to fluid accumulation is associated with heart failure and congenital heart defects. When the heart is unable to circulate blood normally, the kidneys receive less blood, leading to reduced fluid filtration into the urine. The excess fluid accumulates in various body parts such as the lungs, liver, eyes, and sometimes in the legs. Slow pulse rate (Choice A) is less likely as infants with heart failure typically present with tachycardia due to the body compensating for decreased cardiac output. Decreased systolic pressure (Choice C) is also less likely as heart failure typically leads to increased blood pressure as the body tries to maintain adequate perfusion. Irregular white blood cell (WBC) values (Choice D) are not directly associated with congenital heart defects unless there is an underlying infection or inflammatory process.

4. A client had a closed reduction of a fractured right wrist followed by the application of a fiberglass cast 12 hours ago. Which finding requires immediate attention?

• A. Capillary refill of fingers on right hand is 3 seconds
• B. Skin warm to touch and normally colored
• C. Client reports prickling sensation in the right hand
• D. Slight swelling of fingers of right hand

Correct answer: C

Rationale: A prickling sensation in the right hand is indicative of compartment syndrome, a serious condition that can lead to tissue damage and impaired circulation. Immediate attention is required to prevent complications. Capillary refill of 3 seconds, warm and normally colored skin, and slight swelling of fingers are expected findings after a closed reduction and casting. These findings do not typically indicate a critical issue and can be managed with routine monitoring.

5. A child is hospitalized because of persistent vomiting. The nurse should monitor the child closely for which problem?

• A. Diarrhea
• B. Metabolic acidosis
• C. Metabolic alkalosis
• D. Hyperactive bowel sounds

Correct answer: C

Rationale: In the scenario of persistent vomiting, the child is at risk of developing metabolic alkalosis due to the loss of hydrochloric acid. Vomiting leads to the loss of gastric acid, resulting in an imbalance that causes metabolic alkalosis. Metabolic acidosis is incorrect as it would occur in a child with diarrhea due to the loss of bicarbonate. While diarrhea can sometimes be associated with vomiting, in this case, the primary focus is on the effects of vomiting. Hyperactive bowel sounds are not typically associated with vomiting, making this choice less relevant to the situation described.

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