Nursing Elites

1. What is the initial action for treating chest pain in acute coronary syndrome?

• A. Administer sublingual nitroglycerin
• B. Administer aspirin
• C. Check cardiac enzymes
• D. Obtain IV access

Correct answer: A

Rationale: The correct initial action for treating chest pain in acute coronary syndrome is to administer sublingual nitroglycerin. Nitroglycerin helps dilate blood vessels, reducing the workload on the heart and improving blood flow to the heart muscle. Administering aspirin can also be beneficial, but the priority is to address chest pain promptly. Checking cardiac enzymes and obtaining IV access are important steps but are not the initial actions needed to alleviate chest pain in acute coronary syndrome.

2. What should the healthcare provider do first when a patient is admitted with chest pain and possible acute coronary syndrome?

• A. Administer sublingual nitroglycerin
• B. Get IV access
• C. Auscultate heart sounds
• D. Obtain cardiac enzymes

Correct answer: A

Rationale: Administering sublingual nitroglycerin is the priority intervention when a patient presents with chest pain and suspected acute coronary syndrome. Nitroglycerin helps dilate blood vessels, improve blood flow to the heart, and relieve chest pain. It is crucial to address the pain and potential ischemia promptly to prevent further cardiac tissue damage. Getting IV access, auscultating heart sounds, and obtaining cardiac enzymes are important assessments and interventions, but administering nitroglycerin takes precedence in managing acute coronary syndrome.

3. What lab value should be prioritized for a patient with HIV?

• A. CD4 T-cell count below 180 cells/mm3
• B. Serum albumin levels
• C. White blood cell count
• D. Hemoglobin levels

Correct answer: A

Rationale: A CD4 T-cell count below 180 cells/mm3 should be prioritized for a patient with HIV. This value is crucial as it indicates severe immunocompromise in HIV-infected individuals. Monitoring CD4 T-cell count helps assess the status of the immune system and guides treatment decisions. Serum albumin levels (choice B) may reflect the patient's nutritional status and overall health but are not as specific to HIV disease progression. White blood cell count (choice C) and hemoglobin levels (choice D) can be affected by various factors and are not as directly linked to HIV management as the CD4 T-cell count in this context.

4. A nurse is caring for a client who has syndrome of inappropriate antidiuretic hormone (SIADH) and is receiving 3% sodium chloride via continuous IV. Which of the following laboratory findings should the nurse identify as an indication that the SIADH is resolving?

• A. Urine specific gravity 1.020
• B. Sodium 119 mEq/L
• C. BUN 8 mg/dL
• D. Calcium 8.7 mg/dL

Correct answer: A

Rationale: A urine specific gravity of 1.020 is within the expected reference range and indicates that the kidneys are appropriately concentrating urine, which is a sign that the syndrome of inappropriate antidiuretic hormone (SIADH) is resolving. A low sodium level (choice B) is associated with SIADH, so a sodium level of 119 mEq/L is not indicative of resolution. BUN (choice C) and calcium levels (choice D) are typically not directly related to SIADH resolution.

5. What are the expected symptoms in a patient experiencing a thrombotic stroke?

• A. Gradual loss of function on one side of the body
• B. Sudden loss of consciousness
• C. Seizures and convulsions
• D. Severe headache and vomiting

Correct answer: A

Rationale: The correct answer is A: 'Gradual loss of function on one side of the body.' Thrombotic strokes typically result in a gradual onset of symptoms due to a blockage in a blood vessel in the brain, leading to a slow progression of neurological deficits. Choices B, C, and D are incorrect because sudden loss of consciousness, seizures, convulsions, severe headache, and vomiting are more commonly associated with other types of strokes or medical conditions, such as hemorrhagic strokes, epilepsy, or migraines.

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