Nursing Elites

1. The nurse is assessing the patient for the presence of a Chvostek's sign. What electrolyte imbalance does a positive Chvostek's sign indicate?

• A. Hypermagnesemia
• B. Hypomagnesemia
• C. Hypocalcemia
• D. Hyperkalemia

Correct answer: C

Rationale: Chvostek's sign is characterized by a brief contraction of the upper lip, nose, or side of the face and is indicative of hypocalcemia, making choice C the correct answer. Hypomagnesemia (choice B) is associated with Trousseau's sign, not Chvostek's sign. Hypermagnesemia (choice A) is not related to Chvostek's sign. Hyperkalemia (choice D) is not typically associated with Chvostek's sign; instead, it may present with muscle weakness and cardiac arrhythmias.

2. What percentage of body water can be as high as in a newborn?

• A. 80%.
• B. 70%.
• C. 60%.
• D. 90%.

Correct answer: A

Rationale: The correct answer is A: 80%. Newborns can have a body water content as high as 80% due to their higher total body water compared to adults. Choice B (70%) is incorrect because newborns typically have a higher body water percentage. Choice C (60%) is also incorrect as it underestimates the body water content in newborns. Choice D (90%) is incorrect as it overestimates the body water percentage in newborns.

3. A nurse assesses a client who has a radial artery catheter. Which assessment should the nurse complete first?

• A. . Amount of pressure in fluid container
• B. Date of catheter tubing change
• C. Percent of heparin in infusion container
• D. . Presence of an ulnar pulse

Correct answer: D

Rationale:

4. A nurse in the medical-surgical unit has a newly admitted patient who is oliguric; the acute care nurse practitioner orders a fluid challenge of 100 to 200 mL of normal saline solution over 15 minutes. The nurse is aware this intervention will help:

• A. Distinguish hyponatremia from hypernatremia
• B. Evaluate pituitary gland function
• C. Distinguish reduced renal blood flow from decreased renal function
• D. Provide an effective treatment for hypertension-induced oliguria

Correct answer: C

Rationale: Administering a fluid challenge in oliguric patients helps to distinguish reduced renal blood flow from decreased renal function. This intervention aids in determining whether the oliguria is due to reduced renal blood flow (such as in fluid volume deficit or prerenal azotemia) or decreased renal function (such as in acute tubular necrosis). The response to this challenge can indicate the underlying cause. Choices A, B, and D are incorrect as they do not align with the purpose of a fluid challenge in oliguric patients.

5. A nurse is assessing a client who has acute pancreatitis and is at risk for an acid-base imbalance. For which manifestation of this acid-base imbalance should the nurse assess?

• A. Agitation
• B. Kussmaul respirations
• C. Seizures
• D. Positive Chvosteks sign

Correct answer: B

Rationale:

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