Nursing Elites

1. During the first 24 hours after the thermal injury, you should assess Sergio for:

• A. hypokalemia and hypernatremia
• B. hypokalemia and hyponatremia
• C. hyperkalemia and hyponatremia
• D. hyperkalemia and hypernatremia

Correct answer: D

Rationale: During the initial phase after a thermal injury, the major concern is the release of potassium due to cell damage, leading to hyperkalemia. Hypernatremia is not typically a primary concern in the immediate post-injury phase. Hyponatremia is less likely to occur initially after a burn injury. Therefore, the correct assessment for Sergio during the first 24 hours after the thermal injury would be hyperkalemia and hypernatremia.

2. Induction of vomiting is indicated for the accidental poisoning patient who has ingested.

• A. Rust remover C. toilet bowl cleaner
• B. Gasoline D. aspirin
• C.
• D.

Correct answer: D

Rationale: Understanding the underlying pathology and therapeutic techniques ensures that nursing care is not only reactive but also preventative, reducing the risk of complications.

3. A client with Crohn's disease is receiving parenteral nutrition. Which of the following interventions should the nurse not include in the care of this client?

• A. Remove the parenteral nutrition solution from the refrigerator 2 hours before infusion.
• B. Remove unused parenteral nutrition after 12 hours of use.
• C. Monitor daily laboratory values and report abnormalities as needed.
• D. Monitor the flow rate of the parenteral nutrition carefully and adjust it if necessary.

Correct answer: B

Rationale: In caring for a client receiving parenteral nutrition, it is important to follow proper guidelines to ensure safety and effectiveness. Unused parenteral nutrition should be removed after 24 hours, not 12 hours, to prevent contamination and reduce the risk of infection. Option A is correct as it ensures the solution is at room temperature before infusion. Option C is essential for monitoring the client's response to parenteral nutrition. Option D is important to maintain the correct flow rate and adjust it as needed. Therefore, option B is the incorrect choice among the options provided.

4. What is the initial major sign of acute renal failure?

• A. Oliguria
• B. Hematuria
• C. Proteinuria
• D. Glycosuria

Correct answer: A

Rationale: Oliguria, or reduced urine output, is often the initial major sign of acute renal failure. This reduction in urine output indicates that the kidneys are not functioning properly. Hematuria (blood in urine), proteinuria (presence of protein in urine), and glycosuria (presence of glucose in urine) are not typically the initial major signs of acute renal failure. While they may be present in certain conditions, oliguria is the most common and critical indicator of acute renal failure.

5. In preparation for ECT, the nurse knows that it is almost similar to that of:

• A. ECG
• B. General Anesthesia
• C. EEG
• D. MRI

Correct answer: B

Rationale: The correct answer is B: General Anesthesia. In preparation for ECT (Electroconvulsive Therapy), the nurse should be aware that it is almost similar to the process of administering general anesthesia. This similarity is crucial as it involves sedation and muscle relaxation to ensure safety during the procedure. Choice A (ECG) is incorrect because ECT and ECG (Electrocardiogram) serve different purposes and involve distinct procedures. Choice C (EEG) is incorrect as EEG (Electroencephalogram) measures brain activity and is not directly related to ECT. Choice D (MRI) is also incorrect as MRI (Magnetic Resonance Imaging) is a diagnostic imaging procedure that does not involve sedation or muscle relaxation like ECT and general anesthesia.

Similar Questions