Nursing Elites

1. What could suddenly occur in a child with acute epiglottitis?

• A. Increased carbon dioxide levels
• B. Airway obstruction
• C. Inability to swallow
• D. Bronchial collapse

Correct answer: B

Rationale: In acute epiglottitis, the infected epiglottis becomes inflamed and can lead to sudden airway obstruction, which is a life-threatening emergency. This can cause difficulty breathing and necessitates immediate intervention to secure the airway. Increased carbon dioxide levels may occur due to inadequate ventilation resulting from airway obstruction, but the primary concern is the obstruction itself, not the carbon dioxide levels. Inability to swallow may be present due to pain and swelling in the throat but is not the immediate life-threatening complication associated with acute epiglottitis. Bronchial collapse is not a typical consequence of acute epiglottitis.

2. The nurse is evaluating teaching about drug therapy to treat gout. Which statement by the client demonstrates an understanding of the use of allopurinol to treat Gout?

• A. I need to take the prescribed amount of the drug to get rid of my gout.
• B. I need to take this drug every day to keep from having any flare-ups.
• C. I should take this drug when I have gout attacks to reduce symptoms.
• D. The pain and swelling can be controlled by taking this drug every day.

Correct answer: B

Rationale: Taking allopurinol every day helps to prevent gout flare-ups by reducing uric acid levels.

3. A middle-aged man who has a 35-year smoking history presents to the emergency department confused and short of breath. Before starting oxygen, these baseline arterial blood gases (ABGs) are obtained: pH=7.25, pCO2=50 mmHg, HCO3=30 mEq/L. These findings indicate to the nurse that the client is experiencing which acid-base imbalance?

• A. Metabolic acidosis.
• B. Respiratory acidosis.
• C. Metabolic alkalosis.
• D. Respiratory alkalosis.

Correct answer: B

Rationale: The ABG results show a low pH (acidosis) and increased pCO2, indicating respiratory acidosis. In respiratory acidosis, the lungs cannot remove enough CO2, leading to its accumulation in the blood. This often occurs in conditions like COPD and is consistent with the patient's smoking history. Metabolic acidosis (choice A) is characterized by low pH and low HCO3 levels. Metabolic alkalosis (choice C) is marked by high pH and high HCO3 levels. Respiratory alkalosis (choice D) presents with high pH and low pCO2.

4. A client with chronic heart failure is being discharged with a new prescription for furosemide. Which instruction should the nurse include in the discharge teaching?

• A. Increase your intake of potassium-rich foods.
• B. Restrict your fluid intake to 1 liter per day.
• C. Avoid salt substitutes containing potassium.
• D. Weigh yourself once a week.

Correct answer: A

Rationale: The correct answer is to instruct the client to increase their intake of potassium-rich foods. Furosemide is a loop diuretic that can lead to potassium loss due to increased urinary excretion. Potassium-rich foods can help prevent hypokalemia, a potential side effect of furosemide. Restricting fluid intake (choice B) may not be suitable for all patients with heart failure, and a general restriction of 1 liter per day is not typically recommended. Avoiding salt substitutes containing potassium (choice C) is not a priority teaching point in this scenario. Weighing oneself once a week (choice D) is important for monitoring fluid status, but increasing potassium-rich foods is more directly related to the potential side effects of furosemide.

5. An infant has been diagnosed with cradle cap. What is the correct intervention to treat the scalp?

• A. Alcohol
• B. Mineral oil
• C. Calamine
• D. A&D ointment

Correct answer: B

Rationale: Cradle cap is a common condition in infants characterized by crusty patches on the scalp. The correct intervention to treat cradle cap is to apply mineral oil. Mineral oil helps soften the crusty patches, making it easier to remove them gently. Alcohol (Choice A) can be too harsh for an infant's sensitive skin and may cause irritation. Calamine (Choice C) is used to relieve itching associated with conditions like chickenpox or insect bites, not for treating cradle cap. A&D ointment (Choice D) is typically used for diaper rash and minor skin irritations, not for cradle cap.

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