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 preferred electrical intervention for a patient with ventricular tachycardia with a pulse?

• A. Defibrillation
• B. Synchronized cardioversion
• C. Pacing
• D. Medication administration

Correct answer: B

Rationale: Synchronized cardioversion is the preferred electrical intervention for ventricular tachycardia with a pulse. In this scenario, the heart still has an organized rhythm, so synchronized cardioversion is used to deliver a shock at a specific point in the cardiac cycle, aiming to restore a normal rhythm. Defibrillation (Choice A) is used for pulseless ventricular tachycardia or ventricular fibrillation. Pacing (Choice C) may be used for bradycardias or certain types of heart blocks. Medication administration (Choice D) can be considered for stable ventricular tachycardia, but synchronized cardioversion is the primary intervention for ventricular tachycardia with a pulse.

3. What is the correct action when a patient reports cramping during enema administration?

• A. Lower the height of the solution container
• B. Increase the flow of the enema solution
• C. Stop the procedure and remove the tubing
• D. Continue the enema at a slower rate

Correct answer: A

Rationale: The correct action to take when a patient reports cramping during enema administration is to lower the height of the solution container. Lowering the height reduces the pressure and speed of the solution entering the rectum, alleviating cramping. Increasing the flow of the enema solution (Choice B) can worsen the discomfort. Stopping the procedure and removing the tubing (Choice C) is not necessary unless there are severe complications. Continuing the enema at a slower rate (Choice D) may not effectively address the immediate cramping issue and could still cause discomfort to the patient.

4. A nurse is planning care for a patient diagnosed with diabetes insipidus. What should be included in the care plan?

• A. Monitor serum albumin levels
• B. Restrict protein intake to 0.55-0.60 g/kg/day
• C. Encourage the patient to increase fluid intake
• D. Teach the patient to avoid alcohol

Correct answer: A

Rationale: The correct answer is to monitor serum albumin levels. In patients with diabetes insipidus, monitoring serum albumin levels is essential to assess for dehydration and nutritional deficits. Choices B, C, and D are not directly related to managing diabetes insipidus. Restricting protein intake, encouraging fluid intake, and teaching the patient to avoid alcohol are interventions that may be relevant for other medical conditions but are not specific to addressing the needs of a patient with diabetes insipidus.

5. What is the priority dietary modification for a patient with pre-dialysis end-stage kidney disease?

• A. Limit phosphorus intake to 700 mg/day
• B. Increase potassium intake to 3 g/day
• C. Eat three large meals per day
• D. Restrict protein intake to 1 g/kg/day

Correct answer: A

Rationale: The correct answer is A: Limit phosphorus intake to 700 mg/day. In patients with pre-dialysis end-stage kidney disease, restricting phosphorus intake is crucial to manage their condition. Excessive phosphorus can lead to mineral and bone disorders, which are common in kidney disease. Choice B, increasing potassium intake, is not the priority and can be harmful as kidney disease often leads to hyperkalemia. Choice C, eating three large meals per day, is not recommended as smaller, frequent meals are usually better tolerated. Choice D, restricting protein intake to 1 g/kg/day, is important in later stages of kidney disease but is not the priority at the pre-dialysis stage.

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