Nursing Elites

1. What lab value should be prioritized in a patient with HIV?

• A. CD4 T-cell count below 180 cells/mm3
• B. White blood cell count
• C. Serum albumin levels
• 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 indicates the level of immunocompromise. A count below 180 cells/mm3 signifies severe immunocompromise and an increased risk of opportunistic infections. Choices B, C, and D are not the priority lab values in HIV management. While white blood cell count, serum albumin levels, and hemoglobin levels are important, they do not directly reflect the immune status and progression of HIV as the CD4 T-cell count does.

2. A nurse is assessing a client who has meningitis. The nurse should identify which of the following findings as a positive Kernig's sign?

• A. After stroking the lateral area of the foot, the client's toes contract and draw together
• B. After hip flexion, the client is unable to extend their leg completely without pain
• C. The client's voluntary movement is not coordinated
• D. The client reports pain and stiffness when flexing their neck

Correct answer: B

Rationale: A positive Kernig's sign is identified when a client is unable to extend their leg completely without pain after hip flexion. This finding suggests meningeal irritation. Choices A, C, and D do not describe Kernig's sign. Choice A describes a normal plantar reflex, Choice C refers to coordination deficits, and Choice D indicates neck pain and stiffness, which are not related to Kernig's sign.

3. What are the expected ECG findings in hypokalemia?

• A. Flattened T waves
• B. Prominent U waves
• C. Elevated ST segments
• D. Wide QRS complex

Correct answer: A

Rationale: Flattened T waves are the classic ECG finding in hypokalemia. Hypokalemia primarily affects the repolarization phase of the cardiac action potential, leading to T wave abnormalities. While prominent U waves are typically associated with hypokalemia as well, flattened T waves are the most specific and sensitive ECG abnormality seen in hypokalemia. Elevated ST segments and wide QRS complexes are not typically seen in hypokalemia and are more indicative of other electrolyte imbalances or cardiac conditions.

4. What should a healthcare professional monitor in a patient receiving insulin who is at risk for hypoglycemia?

• A. Monitor blood glucose levels
• B. Monitor for respiratory distress
• C. Monitor for muscle weakness
• D. Monitor for hyperkalemia

Correct answer: A

Rationale: Monitoring blood glucose levels is crucial in patients receiving insulin who are at risk for hypoglycemia. Insulin can lower blood sugar levels, potentially leading to hypoglycemia, which can be harmful if not promptly recognized and managed. Checking blood glucose levels allows for early detection of low blood sugar levels, enabling timely interventions to prevent complications. Choices B, C, and D are incorrect as they do not directly relate to monitoring for hypoglycemia in patients receiving insulin.

5. A client is scheduled for an electroencephalogram (EEG) and a nurse is providing teaching. Which of the following statements by the client indicates an understanding of the teaching?

• A. I should not wash my hair prior to the procedure.
• B. I will receive a sedative 1 hour before the procedure.
• C. I should avoid eating prior to the procedure.
• D. I will be exposed to flashes of light during the procedure.

Correct answer: D

Rationale: The correct answer is D. The nurse should inform the client that flashes of light or pictures are often used during the procedure to assess the brain's response to stimuli. Choices A, B, and C are incorrect because washing hair, receiving a sedative, and avoiding eating are not directly related to the EEG procedure.

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