Nursing Elites

1. What are the primary differences between left-sided and right-sided heart failure?

• A. Left-sided: Pulmonary congestion; Right-sided: Systemic edema
• B. Right-sided: Pulmonary congestion; Left-sided: Systemic edema
• C. Left-sided: Systemic edema; Right-sided: Pulmonary congestion
• D. Right-sided: Pulmonary congestion; Left-sided: Heart failure

Correct answer: A

Rationale: The correct answer is A: "Left-sided: Pulmonary congestion; Right-sided: Systemic edema." Left-sided heart failure primarily affects the lungs, leading to pulmonary congestion, which manifests as symptoms like shortness of breath and cough. On the other hand, right-sided heart failure causes systemic congestion and edema, often presenting as swelling in the legs and abdomen due to fluid retention. Choice B is incorrect because it swaps the features of left-sided and right-sided heart failure. Choice C is incorrect as it also incorrectly switches the characteristics of the two types of heart failure. Choice D is incorrect because it inaccurately associates left-sided heart failure with pulmonary congestion and right-sided heart failure with heart failure itself, which is not a distinguishing feature.

2. A client with chronic kidney disease needs dietary restrictions. What restriction is necessary?

• A. Increase protein intake
• B. Limit potassium-rich foods
• C. Increase fluid intake to prevent dehydration
• D. Increase phosphorus intake

Correct answer: B

Rationale: The correct answer is to limit potassium-rich foods for clients with chronic kidney disease. Excessive potassium can be harmful to individuals with compromised kidney function, leading to complications. This restriction helps in managing the condition and preventing further health issues. Choice A is incorrect because increasing protein intake can put additional stress on the kidneys. Choice C is incorrect as excessive fluid intake can burden the kidneys. Choice D is incorrect as increasing phosphorus intake can be harmful for individuals with kidney disease.

3. A nurse on an acute unit has received a change of shift report for 4 clients. Which of the following clients should the nurse assess first?

• A. A client who is 1 hr postoperative and has hypoactive bowel sounds.
• B. A client who has a fractured left tibia and pallor in the affected extremity.
• C. A client who had a cardiac catheterization 3 hr ago and has 3+ pedal pulses.
• D. A client who has an elevated AST level following the administration of azithromycin.

Correct answer: B

Rationale: The correct answer is B because pallor in an extremity after a fracture could indicate compromised circulation, making it a priority for assessment. Choice A is not the priority as hypoactive bowel sounds in a client 1 hr postoperative, while concerning, do not indicate a life-threatening condition. Choice C, a client who had a cardiac catheterization 3 hr ago and has 3+ pedal pulses, indicates good perfusion and does not require immediate attention. Choice D, a client with an elevated AST level following the administration of azithromycin, may require further assessment but is not as urgent as the client with potential compromised circulation in choice B.

4. How should a healthcare provider manage a patient with pneumonia?

• A. Administer antibiotics and provide oxygen therapy
• B. Provide bronchodilators and encourage deep breathing
• C. Administer fluids and encourage bed rest
• D. Monitor for chest pain and provide pain relief

Correct answer: A

Rationale: Correct answer: Administering antibiotics and providing oxygen therapy are essential in managing pneumonia. Antibiotics help treat the infection caused by bacteria, while oxygen therapy improves lung function. Choice B is incorrect because bronchodilators may not be the primary treatment for pneumonia. Choice C is not the priority in pneumonia management, although fluids and rest are important for recovery. Choice D is also not a primary intervention in pneumonia management.

5. A client with diabetes is experiencing hyperglycemia. What is the nurse's priority?

• A. Administer insulin
• B. Encourage the client to exercise to lower blood glucose
• C. Encourage the client to drink water
• D. Administer glucagon

Correct answer: A

Rationale: The correct answer is to administer insulin. In hyperglycemia, there is an excess of glucose in the blood, which needs to be lowered. Insulin is the primary medication used to lower blood glucose levels by facilitating the uptake of glucose into cells. Encouraging the client to exercise may further increase blood glucose levels due to the release of stress hormones, so it is not the priority. While staying hydrated is important, it will not directly address the high blood glucose levels seen in hyperglycemia. Glucagon is used to treat severe hypoglycemia, not hyperglycemia, so it is not the priority in this situation.

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