Nursing Elites

1. What should a healthcare professional monitor for in a patient with compartment syndrome?

• A. Unrelieved pain, pallor, and pulselessness
• B. Localized redness and swelling
• C. Fever and signs of infection
• D. Loss of deep tendon reflexes

Correct answer: A

Rationale: Unrelieved pain, pallor, and pulselessness are classic signs of compartment syndrome. In this condition, increased pressure within a muscle compartment impairs blood flow, leading to severe pain that is not relieved by usual measures, pallor from decreased blood flow, and pulselessness due to compromised circulation. These signs indicate a medical emergency requiring immediate intervention. Localized redness and swelling (Choice B) are more characteristic of inflammation or infection rather than compartment syndrome. Fever and signs of infection (Choice C) are not typical manifestations of compartment syndrome. Loss of deep tendon reflexes (Choice D) is associated with conditions affecting the nervous system, not compartment syndrome.

2. What is the purpose of an escharotomy?

• A. To relieve pressure and improve circulation in burn injuries
• B. To reduce pain in the affected area
• C. To remove necrotic tissue from a wound
• D. To prevent infection from spreading

Correct answer: A

Rationale: An escharotomy is performed to relieve pressure and improve circulation in areas affected by deep burns. This procedure helps prevent complications such as compartment syndrome by releasing the constricting eschar. Choice B is incorrect because while pain relief may be a secondary outcome of the procedure, the primary purpose is to address pressure and circulation issues. Choice C is incorrect as an escharotomy specifically focuses on releasing pressure, not removing necrotic tissue. Choice D is incorrect as the primary goal of an escharotomy is not to prevent infection but rather to address the immediate issues related to deep burn injuries.

3. When planning care for a patient with diabetes insipidus, what should the nurse include in the plan?

• A. Monitor serum albumin levels
• B. Avoid alcohol
• C. Teach the patient to increase fluids
• D. Increase exercise to reduce stress

Correct answer: B

Rationale: The correct answer is B: 'Avoid alcohol.' Alcohol consumption can exacerbate dehydration in patients with diabetes insipidus, so it is essential to advise them to avoid alcohol. Monitoring serum albumin levels (choice A) is not directly related to managing diabetes insipidus. Teaching the patient to increase fluids (choice C) is not recommended as it can worsen the condition by further diluting the urine. Increasing exercise to reduce stress (choice D) is not a primary intervention for managing diabetes insipidus.

4. A home health nurse is providing teaching to the family of a client who has a seizure disorder. Which of the following interventions should the nurse include in the teaching?

• A. Keep a padded tongue depressor near the bedside
• B. Place a pillow under the client's head during a seizure
• C. Administer diazepam intravenously at the onset of seizures
• D. Position the client on their side during a seizure

Correct answer: D

Rationale: The correct intervention for a client who has a seizure disorder is to position the client on their side during a seizure. This helps to prevent aspiration and ensures a patent airway. Keeping a padded tongue depressor near the bedside (Choice A) is not recommended as it can cause injury during a seizure. Placing a pillow under the client's head during a seizure (Choice B) is also not advised as it can obstruct the airway. Administering diazepam intravenously at the onset of seizures (Choice C) is not typically done at home without healthcare provider direction.

5. A nurse is assessing a client who has a sodium level of 122 mEq/L. Which of the following findings should the nurse expect?

• A. Decreased deep tendon reflexes
• B. Positive Chvostek's sign
• C. Hyperactive bowel sounds
• D. Dry mucous membranes

Correct answer: A

Rationale: Corrected deep tendon reflexes occur with hyponatremia. Other manifestations of hyponatremia include headache, confusion, lethargy, fatigue, seizures, and muscle weakness. Positive Chvostek's sign is associated with hypocalcemia, hyperactive bowel sounds are not typically related to hyponatremia, and dry mucous membranes are more commonly seen with dehydration.

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