Nursing Elites

1. How does hyponatremia place the patient at risk?

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

Correct answer: C

Rationale: Hyponatremia places the patient at risk for cardiac dysrhythmias. While hyponatremia can lead to seizures due to cerebral edema caused by fluid imbalance, the most immediate and life-threatening risk is cardiac dysrhythmias. Low sodium levels can disrupt the heart's electrical activity, potentially leading to fatal arrhythmias. Although fatigue and muscle weakness are symptoms of hyponatremia, cardiac dysrhythmias pose the most critical concern as they can have severe consequences.

2. What is the priority action when the nurse administers insulin for a misread blood glucose reading?

• A. Monitor for signs of hypoglycemia
• B. Monitor for hyperglycemia
• C. Administer glucose IV
• D. Document the incident

Correct answer: A

Rationale: The priority action when the nurse administers insulin for a misread blood glucose reading is to monitor for signs of hypoglycemia. Insulin administration based on a misread blood glucose could lead to hypoglycemia due to an unnecessary dose. Monitoring for signs of hypoglycemia is crucial for prompt intervention if blood glucose levels drop dangerously low. Option B, monitoring for hyperglycemia, is incorrect in this situation as the concern is over-treatment with insulin causing hypoglycemia. Option C, administering glucose IV, is only necessary if hypoglycemia occurs. Option D, documenting the incident, is important for reporting and learning purposes but is not the immediate priority when the focus is on patient safety and preventing complications.

3. What dietary recommendations should be provided to a patient with GERD?

• A. Avoid mint and spicy foods
• B. Eat large meals before bed
• C. Consume liquids with meals
• D. Avoid foods high in potassium

Correct answer: A

Rationale: The correct recommendation for a patient with GERD is to avoid mint and spicy foods. These types of foods can trigger acid reflux and worsen GERD symptoms. Choice B is incorrect as eating large meals before bed can increase the likelihood of acid reflux due to increased pressure on the lower esophageal sphincter. Choice C is also incorrect as consuming liquids with meals can cause distension in the stomach, potentially leading to reflux. Choice D is not directly related to GERD, as foods high in potassium are generally healthy and not specifically problematic for GERD patients.

4. What is the primary concern in a patient with a low CD4 T-cell count in HIV?

• A. Increased risk of infection
• B. Increased risk of bleeding
• C. Decreased immunity leading to opportunistic infections
• D. Increased risk of cardiac complications

Correct answer: A

Rationale: The correct answer is A: Increased risk of infection. In HIV patients with a low CD4 T-cell count, the primary concern is the increased susceptibility to infections due to compromised immunity. This compromised immune system can lead to various infections, making infection control crucial. Choice B, increased risk of bleeding, is not directly associated with a low CD4 count in HIV. Option C, decreased immunity leading to opportunistic infections, conveys a similar concern as the correct answer but lacks specificity. Choice D, increased risk of cardiac complications, is not typically the primary concern in HIV patients with a low CD4 count, as infections and opportunistic diseases pose more immediate threats to health.

5. A nurse is providing discharge teaching to a client following a heart transplant. Which of the following information should the nurse include in the teaching?

• A. Immunosuppressant medications need to be taken for up to 1 year
• B. Shortness of breath might be an indication of transplant rejection
• C. The surgical site will heal in 3 to 4 weeks after surgery
• D. Begin 45 minutes of moderate aerobic exercise per day following discharge

Correct answer: B

Rationale: The correct answer is B. Shortness of breath is an important sign of transplant rejection. Other manifestations of rejection include fatigue, edema, bradycardia, and hypotension. Choices A, C, and D are incorrect because: A) Immunosuppressant medications are typically required for life, not just up to 1 year. C) The surgical site healing time can vary and may take longer than 3 to 4 weeks. D) Starting a specific exercise regimen should be individualized and guided by healthcare providers; a general recommendation like 45 minutes of exercise per day may not be suitable for all heart transplant recipients.

Similar Questions