Nursing Elites

1. The nurse is caring for a patient who has had severe vomiting. The patient’s serum sodium level is 130 mEq/L. The nurse will expect the patient’s provider to order which treatment?

• A. Diuretic therapy
• B. Intravenous hypertonic 5% saline
• C. Intravenous normal saline 0.9%
• D. Oral sodium supplements

Correct answer: C

Rationale: In this scenario, the patient has hyponatremia with a serum sodium level of 130 mEq/L. For a serum sodium level between 125 and 135 mEq/L, the appropriate treatment is intravenous normal saline 0.9%. Normal saline helps to increase the sodium content in the vascular fluid. Diuretic therapy would exacerbate sodium and fluid depletion, which is not suitable for a patient already dehydrated from severe vomiting. Intravenous hypertonic 5% saline is typically reserved for severe hyponatremia with a serum sodium level below 120 mEq/L. Oral sodium supplements are not feasible in this case as the patient is vomiting and may not be able to tolerate oral intake easily.

2. Which food is most important to encourage a client with osteomalacia to include in a daily diet?

• A. Fortified milk and cereals
• B. Citrus fruits and juices
• C. Green leafy vegetables
• D. Red meats and eggs

Correct answer: A

Rationale: The correct answer is A: Fortified milk and cereals. Osteomalacia is a condition caused by a deficiency in vitamin D. Fortified milk and cereals are rich sources of vitamin D, which is essential for managing osteomalacia. Citrus fruits and juices (choice B) are high in vitamin C, but vitamin D is the primary concern for osteomalacia. Green leafy vegetables (choice C) are good sources of various nutrients but not the main focus for managing osteomalacia. Red meats and eggs (choice D) are good sources of protein and other nutrients but are not as critical as fortified milk and cereals for addressing vitamin D deficiency in osteomalacia.

3. The nurse is preparing to administer the first dose of an antibiotic to a patient admitted for a urinary tract infection. Which action is most important prior to administering the antibiotic?

• A. Administering a small test dose to determine if hypersensitivity exists
• B. Having epinephrine available in case of a severe hypersensitivity reaction
• C. Monitoring baseline vital signs, including temperature and blood pressure
• D. Obtaining a specimen for culture and sensitivity

Correct answer: D

Rationale: The most crucial action before administering an antibiotic for a urinary tract infection is to obtain a specimen for culture and sensitivity. This ensures the accurate identification of the causative organism and helps determine the most effective antibiotic therapy. Administering a test dose to detect hypersensitivity is usually reserved for cases with a strong suspicion of allergy to a needed antibiotic. Keeping epinephrine available is important when there is a significant risk of a severe allergic reaction. Monitoring baseline vital signs is essential during antibiotic therapy but is not the top priority before administering the first dose.

4. Assessment of the diabetic client for common complications should include examination of the:

• A. Abdomen.
• B. Lymph glands.
• C. Pharynx.
• D. Eyes.

Correct answer: D

Rationale: The correct answer is D: Eyes. Diabetic clients are at high risk of developing complications such as diabetic retinopathy, making regular eye examinations crucial. Assessing the eyes helps in early detection and management of diabetic eye diseases. Choices A, B, and C are incorrect because while they may be relevant in certain assessments, they are not commonly associated with complications specific to diabetes. Examination of the abdomen, lymph glands, and pharynx are not typically part of routine assessments for common complications in diabetic clients.

5. Which electrolyte imbalance is most likely to be seen in a patient with chronic kidney disease?

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

Correct answer: B

Rationale: In chronic kidney disease, hyperkalemia is the most common electrolyte imbalance due to the kidneys' reduced ability to excrete potassium. This impaired kidney function leads to potassium retention in the body, resulting in elevated serum potassium levels. Hypernatremia (increased sodium levels) is less likely in chronic kidney disease as the kidneys typically still function to regulate sodium levels. Hypocalcemia (low calcium levels) is not a prominent electrolyte imbalance in chronic kidney disease unless there are additional factors involved. Hypokalemia (low potassium levels) is less common in chronic kidney disease, as the primary issue is usually potassium retention rather than deficiency.

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