Nursing Elites

1. What is an escharotomy and when is it performed?

• A. A surgical incision to release pressure in burn injuries
• B. A procedure to remove dead tissue from wounds
• C. An incision to improve circulation in tight skin after burns
• D. A procedure to remove excess fluid from the chest

Correct answer: A

Rationale: An escharotomy is a surgical incision made to release pressure in a part of the body that has a deep burn and excessive swelling. This procedure is crucial in preventing further damage due to restricted blood flow and compromised circulation. Choice B is incorrect because it describes debridement, which is the removal of dead tissue from wounds. Choice C is incorrect as it does not specifically address the purpose of relieving pressure in burn injuries. Choice D is incorrect as it describes a procedure more related to thoracentesis, which is the removal of excess fluid from the chest, typically the pleural space.

2. What is the most likely cause of continuous bubbling in the water seal chamber of a chest tube?

• A. An air leak
• B. A blockage in the chest tube
• C. Normal chest tube function
• D. Drainage from the chest tube

Correct answer: A

Rationale: Continuous bubbling in the water seal chamber of a chest tube usually indicates an air leak. An air leak can disrupt the negative pressure required for the chest tube to function properly, leading to inadequate drainage and potential complications. A blockage in the chest tube would typically result in decreased or absent drainage rather than continuous bubbling. Normal chest tube function does not involve continuous bubbling in the water seal chamber. Drainage from the chest tube may lead to fluid moving into the drainage system, but it would not cause continuous bubbling in the water seal chamber.

3. A nurse is teaching a group of clients about the risk factors for osteoporosis. Which of the following should the nurse include as a risk factor for osteoporosis?

• A. Early menopause
• B. History of falls
• C. African American race
• D. Obesity

Correct answer: A

Rationale: The correct answer is A: Early menopause. A client who goes into early menopause, from natural or surgical causes, is at a greater risk for developing osteoporosis due to the rapid drop in estrogen levels. Choice B, history of falls, is not a direct risk factor for osteoporosis but rather a risk for fractures related to osteoporosis. Choice C, African American race, is actually associated with a lower risk of osteoporosis. Choice D, obesity, is considered a protective factor against osteoporosis as excess weight can provide additional support to bones.

4. What are the expected manifestations of a thrombotic stroke?

• A. Gradual loss of function on one side of the body
• B. Loss of sensation in the affected extremity
• C. Sudden loss of consciousness
• D. Seizures and convulsions

Correct answer: A

Rationale: The correct answer is A: Gradual loss of function on one side of the body. Thrombotic strokes are caused by a clot forming in a blood vessel supplying the brain, leading to a gradual onset of symptoms due to impaired blood flow to specific brain regions. Choices B, C, and D are incorrect because loss of sensation, sudden loss of consciousness, seizures, and convulsions are not typically associated with thrombotic strokes. In a thrombotic stroke, the symptoms develop slowly over time, often over minutes to hours, and include manifestations such as weakness, numbness, or paralysis on one side of the body, along with other symptoms related to the affected brain area.

5. What dietary recommendations are given to a patient with pre-dialysis end-stage kidney disease?

• A. Reduce phosphorus intake to 700 mg/day
• B. Increase sodium intake
• C. Restrict protein intake to 0.55-0.60 g/kg/day
• D. Increase protein intake

Correct answer: A

Rationale: The correct recommendation for a patient with pre-dialysis end-stage kidney disease is to reduce phosphorus intake to 700 mg/day. Excessive phosphorus intake can be harmful to individuals with kidney disease as their kidneys may not be able to excrete it efficiently. Choice B is incorrect because increasing sodium intake is generally not recommended for patients with kidney disease, as it can contribute to fluid retention and high blood pressure. Choice C is incorrect as protein restriction is commonly advised for individuals with advanced kidney disease to reduce the workload on the kidneys. Choice D is also incorrect as increasing protein intake can further burden the kidneys.

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