Nursing Elites

1. What ECG changes are expected in hypokalemia?

• A. Flattened T waves on ECG
• B. Prominent U waves on ECG
• C. Widened QRS complexes on ECG
• D. ST elevation on ECG

Correct answer: A

Rationale: In hypokalemia, flattened T waves are a common ECG finding due to the decreased extracellular potassium affecting repolarization. Prominent U waves are typically seen in hypokalemia as well, but flattened T waves are the more specific and early ECG change. Widened QRS complexes are associated with hyperkalemia, not hypokalemia. ST elevation is often seen in conditions like myocardial infarction, pericarditis, or early repolarization syndrome, not specifically in hypokalemia.

2. What recommendations should the nurse provide to a patient diagnosed with GERD?

• A. Avoid items like mint that increase gastric acid secretion
• B. Eat small, frequent meals
• C. Avoid eating 1 hour before bedtime
• D. Avoid black and red pepper

Correct answer: A

Rationale: The correct answer is A: 'Avoid items like mint that increase gastric acid secretion.' Mint can relax the lower esophageal sphincter, leading to increased gastric acid secretion and worsening GERD symptoms. Choice B is a good recommendation for GERD management as it helps prevent excessive stomach distension. Choice C is also a recommended practice to avoid reflux during sleep. Choice D, avoiding black and red pepper, is not directly linked to exacerbating GERD symptoms, so it is not the most relevant recommendation for a patient diagnosed with GERD.

3. A nurse misreads a blood glucose level and administers excess insulin. What should the nurse monitor for?

• A. Monitor for hyperglycemia
• B. Monitor for hypoglycemia
• C. Administer glucose IV
• D. Monitor for increased thirst

Correct answer: B

Rationale: The correct answer is to monitor for hypoglycemia. Excess insulin can lead to low blood glucose levels, causing hypoglycemia. Symptoms of hypoglycemia include sweating, trembling, dizziness, confusion, and in severe cases, loss of consciousness. Options A, C, and D are incorrect because administering excess insulin would not lead to hyperglycemia or increased thirst, and administering glucose IV would exacerbate the issue by further lowering blood glucose levels.

4. While administering a blood transfusion, a nurse suspects that the client is having an adverse reaction. Which of the following actions should the nurse take first?

• A. Maintain IV access
• B. Obtain the client's vital signs
• C. Contact the provider
• D. Stop the transfusion

Correct answer: D

Rationale: The correct first action for the nurse to take when suspecting an adverse reaction to a blood transfusion is to stop the transfusion immediately. Stopping the transfusion helps prevent further harm to the client. Maintaining IV access and obtaining vital signs are important steps but come after stopping the transfusion in this situation. Contacting the provider can be done after ensuring the client's safety by stopping the transfusion.

5. What should be taught to a patient following cataract surgery?

• A. Avoid NSAIDs
• B. Wear dark glasses when outdoors
• C. Report green or yellow drainage immediately
• D. Itching is normal unless accompanied by pain and nausea

Correct answer: A

Rationale: The correct answer is to avoid NSAIDs after cataract surgery to reduce the risk of bleeding. Choice B, wearing dark glasses when outdoors, is generally recommended after cataract surgery to protect the eyes from bright sunlight, but it is not the most critical instruction. Choice C, reporting green or yellow drainage immediately, is important to monitor for signs of infection, but it is not specific to cataract surgery. Choice D, itching is normal unless accompanied by pain and nausea, is not the most crucial advice post-cataract surgery. Therefore, the key instruction is to avoid NSAIDs to minimize bleeding risk.

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