Nursing Elites

1. What is the main force that pushes fluid in blood capillaries?

• A. Blood pressure.
• B. Sodium in the blood plasma.
• C. Sodium in the interstitial fluid.
• D. Protein in the blood plasma.

Correct answer: A

Rationale: The correct answer is A, blood pressure. Blood pressure is the primary force that pushes fluid out of the capillaries into the surrounding tissues. This pressure difference is essential for the exchange of nutrients, gases, and waste products between the blood and tissues. Choices B, C, and D are incorrect as they do not represent the primary force responsible for pushing fluid in blood capillaries.

2. The ICU nurse is caring for a patient who experienced trauma in a workplace accident. The patient is complaining of having trouble breathing with abdominal pain. An ABG reveals the following results: pH 7.28, PaCO2 50 mm Hg, HCO3 23 mEq/L. The nurse should recognize the likelihood of what acidbase disorder?

• A. Respiratory acidosis
• B. Metabolic alkalosis
• C. Respiratory alkalosis
• D. Mixed acidbase disorder

Correct answer: D

Rationale:

3. Which electrolyte is important in the formation of the thyroid hormones?

• A. Sodium
• B. Iodine
• C. Iron
• D. Chloride

Correct answer: B

Rationale: Iodine is the correct answer because it is essential for the synthesis of thyroid hormones. The thyroid gland incorporates iodine into thyroid hormones such as thyroxine (T4) and triiodothyronine (T3). These hormones are crucial for regulating metabolism, growth, and development. Sodium, iron, and chloride are not directly involved in the formation of thyroid hormones, making them incorrect choices.

4. A patient with hypokalemia and heart failure is admitted to the telemetry unit. The nurse is aware that hypokalemia could cause which of the following abnormalities on an electrocardiogram (ECG)?

• A. Shortened P-R interval
• B. Inverted T wave
• C. Depressed U wave
• D. Elevated U wave

Correct answer: D

Rationale: The correct answer is D: Elevated U wave. Hypokalemia is associated with ECG changes such as an elevated U wave and flattened T waves. Choice A, a shortened P-R interval, is not typically seen in hypokalemia. Choice B, an inverted T wave, is more commonly associated with ischemia or CNS injury rather than hypokalemia. Choice C, a depressed U wave, is not a typical ECG abnormality seen in hypokalemia. Therefore, the correct ECG abnormality associated with hypokalemia is an elevated U wave.

5. A female patient is discharged from the hospital after having an episode of heart failure. She's prescribed daily oral doses of digoxin (Lanoxin) and furosemide (Lasix). Two days later, she tells her community health nurse that she feels weak and her heart 'flutters' frequently. What action should the nurse take?

• A. Tell the patient to rest more frequently.
• B. Advise the patient to discontinue digoxin and contact the physician.
• C. Contact the physician, report the symptoms, and request a blood sample to determine the patient's potassium level.
• D. Instruct the patient to avoid caffeine-containing foods.

Correct answer: C

Rationale: The correct action for the nurse to take is to contact the physician, report the patient's symptoms, and request a blood sample to determine the patient's potassium level. Furosemide, a potassium-wasting diuretic, can lead to hypokalemia, causing weakness and palpitations. Therefore, checking the potassium level is crucial in this situation. Simply telling the patient to rest more frequently won't address the underlying issue of potassium depletion. While digoxin can cause adverse effects, in this case, the symptoms are more likely related to furosemide-induced potassium loss. Instructing the patient to avoid caffeine-containing foods may be beneficial in general, but it wouldn't directly address the potassium depletion that needs urgent attention.

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