Nursing Elites

1. The LPN/LVN is assisting in caring for a client in the telemetry unit and is monitoring the client for cardiac changes indicative of hypokalemia. Which occurrence noted on the cardiac monitor indicates the presence of hypokalemia?

• A. Tall, peaked T waves
• B. ST-segment depression
• C. Prolonged P-R interval
• D. Widening of the QRS complex

Correct answer: B

Rationale: ST-segment depression can indicate hypokalemia, affecting the heart's electrical conduction. Hypokalemia leads to alterations in the repolarization phase of the cardiac action potential, resulting in ST-segment depression on the ECG. Tall, peaked T waves are indicative of hyperkalemia, not hypokalemia. A prolonged P-R interval is more commonly associated with first-degree heart block. Widening of the QRS complex is typically seen in conditions like bundle branch blocks or ventricular tachycardia, not specifically in hypokalemia.

2. The nurse is preparing to administer an intravenous dose of potassium chloride to a client with hypokalemia. The nurse should monitor for which potential complication?

• A. Hyperkalemia
• B. Hypokalemia
• C. Hypernatremia
• D. Hypercalcemia

Correct answer: A

Rationale: When administering potassium chloride to a client with hypokalemia, the nurse should monitor for hyperkalemia. Potassium chloride supplementation aims to increase potassium levels in individuals with hypokalemia. However, excessive administration can lead to hyperkalemia, which can be a serious and potentially life-threatening complication. Monitoring potassium levels is crucial to prevent this adverse outcome. Hypokalemia (Choice B) is the condition being treated, so it is not a complication of treatment. Hypernatremia (Choice C) refers to high sodium levels and is not directly related to the administration of potassium chloride. Hypercalcemia (Choice D) is an elevated calcium level and is not a common complication associated with potassium chloride administration in hypokalemia.

3. When assisting a hospitalized client newly diagnosed with coronary artery disease (CAD) to make appropriate selections from the dietary menu, which meal should the nurse encourage the client to select?

• A. Sausage, pancakes, and toast
• B. Broccoli, buttered rice, and grilled chicken
• C. Hamburger, baked apples, and avocado salad
• D. Fresh strawberries, steamed vegetables, and baked fish

Correct answer: D

Rationale: The correct choice is D: Fresh strawberries, steamed vegetables, and baked fish. This meal is low in saturated fats and cholesterol, which is suitable for a client with CAD. It aligns with dietary recommendations to support heart health and manage CAD. Choices A, B, and C are less appropriate as they contain higher levels of saturated fats and cholesterol, which are not ideal for individuals with CAD.

4. A client with a history of myocardial infarction (MI) is being discharged with a prescription for nitroglycerin sublingual tablets. Which instruction should the nurse reinforce?

• A. Store the tablets in a cool, dry place away from light.
• B. Take a tablet every 5 minutes if chest pain occurs.
• C. Place the tablets under the tongue for sublingual absorption.
• D. Take the tablets without water for faster effect.

Correct answer: A

Rationale: The correct answer is A. Nitroglycerin tablets are light and moisture-sensitive, so they should be stored in a cool, dry place away from light to maintain their effectiveness. Option B advises taking a tablet every 5 minutes, which may lead to overdose as this frequency is too high. Option C emphasizes the correct administration route for sublingual tablets. Option D is incorrect as water is not needed for the tablets to take effect.

5. A healthcare professional is assessing a client who has a new prescription for furosemide. Which of the following findings should the healthcare professional report to the provider?

• A. Weight gain
• B. Dry cough
• C. Hypokalemia
• D. Increased appetite

Correct answer: C

Rationale: The correct answer is C: Hypokalemia. Hypokalemia is a common electrolyte imbalance associated with furosemide use due to its diuretic effect, which can lead to potassium loss. It is crucial to report hypokalemia promptly to the provider as it can result in serious complications such as cardiac arrhythmias. Monitoring and managing potassium levels are essential in patients taking furosemide to prevent adverse effects related to electrolyte imbalances. Choices A, B, and D are incorrect findings to report in a client prescribed furosemide. Weight gain is not typically associated with furosemide use, a dry cough is more commonly linked to ACE inhibitors, and increased appetite is not a common adverse effect of furosemide.

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