Nursing Elites

1. What is the priority lab value for monitoring 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: The correct answer is A: CD4 T-cell count below 180 cells/mm3. Monitoring the CD4 T-cell count is crucial in patients with HIV as it serves as a key indicator of immune function. A count below 180 cells/mm3 indicates severe immunocompromise and an increased risk of opportunistic infections. Choice B, serum albumin levels, though important for assessing nutritional status, is not the priority lab value for HIV monitoring. Choice C, white blood cell count, is a nonspecific measure of immune function and may not accurately reflect the status of the immune system in HIV patients. Choice D, hemoglobin levels, are essential for evaluating anemia but are not the primary lab value for monitoring HIV.

2. What is the priority action for a patient with chest pain from acute coronary syndrome?

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

Correct answer: A

Rationale: The correct answer is to administer sublingual nitroglycerin. This medication helps dilate the blood vessels, reducing the workload of the heart and improving blood flow to the heart muscle, which is crucial in the management of acute coronary syndrome. Checking cardiac enzymes (choice B) is important for diagnosing a heart attack but is not the priority over providing immediate relief to the patient's chest pain. Administering aspirin (choice C) is also important in acute coronary syndrome to prevent further clot formation, but it is not the priority action for immediate pain relief. Obtaining IV access (choice D) is necessary for administering medications or fluids; however, in this scenario, providing sublingual nitroglycerin for prompt pain relief takes precedence.

3. What are the early signs of compartment syndrome?

• A. Unrelieved pain, pallor, and pulselessness
• B. Localized redness and swelling
• C. Fever and infection
• D. Loss of sensation in the affected area

Correct answer: A

Rationale: The correct answer is A: Unrelieved pain, pallor, and pulselessness. These signs are typical early indicators of compartment syndrome, suggesting compromised circulation. Choice B, localized redness and swelling, can be seen in conditions like cellulitis but are not specific to compartment syndrome. Choice C, fever and infection, are not characteristic early signs of compartment syndrome. Choice D, loss of sensation in the affected area, is more indicative of nerve damage rather than being one of the early signs of compartment syndrome.

4. A nurse is teaching a client who has type 1 DM about hypoglycemia. Which of the following statements by the client indicates an understanding of the teaching?

• A. Exercise reduces the risk for hypoglycemia.
• B. I can skip my insulin when I don't eat.
• C. I can drink 4 oz of soda if my blood sugar is low.
• D. Diabetic pills don't cause hypoglycemia; only insulin does.

Correct answer: C

Rationale: The client can correct any development of hypoglycemia with a quick intake of glucose. The client should have 15 g carbohydrates on hand to treat hypoglycemic episodes, like 4 oz of regular soda.

5. What dietary modifications are recommended for a patient with pre-dialysis kidney disease?

• A. Limit phosphorus intake to 700 mg/day
• B. Increase sodium intake to 3 g/day
• C. Restrict protein intake to 0.55-0.60 g/kg/day
• D. Eat three large meals per day

Correct answer: A

Rationale: The correct answer is A: Limit phosphorus intake to 700 mg/day. Patients with pre-dialysis kidney disease should limit phosphorus intake to prevent further kidney damage. Excessive phosphorus can lead to mineral and bone disorders. Choice B is incorrect because increasing sodium intake is not recommended in pre-dialysis kidney disease. Choice C is incorrect as protein restriction is a common recommendation in advanced kidney disease, not pre-dialysis. Choice D is incorrect as eating three large meals per day is not a specific dietary modification for pre-dialysis kidney disease.

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