Nursing Elites

1. What are the manifestations of increased intracranial pressure (IICP)?

• A. Restlessness, confusion, irritability
• B. Severe nausea and vomiting
• C. Elevated blood pressure and bradycardia
• D. Decreased heart rate and altered pupil response

Correct answer: A

Rationale: The correct manifestations of increased intracranial pressure (IICP) include restlessness, confusion, and irritability. These symptoms are a result of the brain being under pressure inside the skull. Severe nausea and vomiting (Choice B) are more commonly associated with increased intracranial pressure in children. Elevated blood pressure and bradycardia (Choice C) are not typical manifestations of increased intracranial pressure; instead, hypertension and bradycardia may be seen in Cushing's reflex, which is a late sign of increased IICP. Decreased heart rate and altered pupil response (Choice D) are also not primary manifestations of increased intracranial pressure, although altered pupil response, like a non-reactive or dilated pupil, can be seen in some cases.

2. What lab value should be prioritized for a patient with HIV?

• A. CD4 T-cell count below 180 cells/mm3
• B. Serum albumin levels
• C. White blood cell count
• D. Hemoglobin levels

Correct answer: A

Rationale: A CD4 T-cell count below 180 cells/mm3 should be prioritized for a patient with HIV. This value is crucial as it indicates severe immunocompromise in HIV-infected individuals. Monitoring CD4 T-cell count helps assess the status of the immune system and guides treatment decisions. Serum albumin levels (choice B) may reflect the patient's nutritional status and overall health but are not as specific to HIV disease progression. White blood cell count (choice C) and hemoglobin levels (choice D) can be affected by various factors and are not as directly linked to HIV management as the CD4 T-cell count in this context.

3. What are the expected ECG findings in hypokalemia?

• A. Flattened T waves
• B. Prominent U waves
• C. Elevated ST segments
• D. Wide QRS complex

Correct answer: A

Rationale: Flattened T waves are the classic ECG finding in hypokalemia. Hypokalemia primarily affects the repolarization phase of the cardiac action potential, leading to T wave abnormalities. While prominent U waves are typically associated with hypokalemia as well, flattened T waves are the most specific and sensitive ECG abnormality seen in hypokalemia. Elevated ST segments and wide QRS complexes are not typically seen in hypokalemia and are more indicative of other electrolyte imbalances or cardiac conditions.

4. A nurse is caring for a client who has syndrome of inappropriate antidiuretic hormone (SIADH) and is receiving 3% sodium chloride via continuous IV. Which of the following laboratory findings should the nurse identify as an indication that the SIADH is resolving?

• A. Urine specific gravity 1.020
• B. Sodium 119 mEq/L
• C. BUN 8 mg/dL
• D. Calcium 8.7 mg/dL

Correct answer: A

Rationale: A urine specific gravity of 1.020 is within the expected reference range and indicates that the kidneys are appropriately concentrating urine, which is a sign that the syndrome of inappropriate antidiuretic hormone (SIADH) is resolving. A low sodium level (choice B) is associated with SIADH, so a sodium level of 119 mEq/L is not indicative of resolution. BUN (choice C) and calcium levels (choice D) are typically not directly related to SIADH resolution.

5. What is the expected ECG finding in a patient with hypokalemia?

• A. Flattened T waves
• B. Elevated ST segments
• C. Widened QRS complexes
• D. Widened QRS complexes on the ECG

Correct answer: A

Rationale: The correct answer is A: Flattened T waves. In hypokalemia, there is a decrease in serum potassium levels, which can lead to various ECG changes. One of the classic ECG findings associated with hypokalemia is the presence of flattened T waves. These T wave abnormalities are typically seen in multiple leads. Choice B, elevated ST segments, is not a typical ECG finding in hypokalemia. Choice C, widened QRS complexes, is more commonly associated with hyperkalemia rather than hypokalemia. Choice D is redundant and not a standard way of describing ECG findings.

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