Nursing Elites

1. When educating a client about to undergo a pacemaker insertion, the nurse explains the normal phases of cardiac muscle tissue. During the repolarization phase, the nurse will stress that membranes must be repolarized before they can be re-excited. Within the cell, the nurse understands that:

• A. Potassium channels open while sodium channels close, causing repolarization to the resting state.
• B. The influx of calcium is the primary stimulus for the repolarization of cardiac tissue.
• C. Only the electrical activity within the heart will determine when repolarization occurs.
• D. The cell membranes need to stay calm, resulting in muscle tissue becoming refractory.

Correct answer: A

Rationale: During the repolarization phase of cardiac muscle tissue, potassium channels open while sodium channels close. This process is crucial for the cardiac muscle to return to its resting state after depolarization. Potassium moving out of the cell and sodium staying out helps reset the membrane potential and prepare the cell for the next depolarization phase. The influx of calcium is not the primary stimulus for repolarization in cardiac tissue; it is mainly involved in the depolarization phase. While electrical activity within the heart influences repolarization, the specific ion movements described in choice A are what physiologically drive repolarization. Cell membranes need to be in an active state during repolarization, not calm, to facilitate the necessary ion movements for muscle tissue to properly function.

2. What laboratory tests should the nurse monitor regularly when a male patient is receiving androgen therapy?

• A. Monitor liver function tests regularly.
• B. Monitor renal function tests regularly.
• C. Monitor blood glucose levels regularly.
• D. Monitor complete blood count (CBC) regularly.

Correct answer: A

Rationale: The correct answer is to monitor liver function tests regularly when a male patient is receiving androgen therapy. Androgen therapy can impact liver function, making it crucial to monitor liver function tests to assess any potential adverse effects on the liver. Renal function tests (choice B) are not typically affected by androgen therapy and do not need specific monitoring for this treatment. Blood glucose levels (choice C) are more relevant in conditions like diabetes or with medications affecting blood sugar, not typically in androgen therapy. Complete blood count (CBC) (choice D) is not directly impacted by androgen therapy and is not a priority for monitoring in this context.

3. A 21-year-old female was recently diagnosed with iron deficiency anemia. In addition to fatigue and weakness, which of the following clinical signs and symptoms would she most likely exhibit?

• A. Hyperactivity
• B. Spoon-shaped nails
• C. Gait problems
• D. Petechiae

Correct answer: B

Rationale: The correct answer is B: Spoon-shaped nails. In iron deficiency anemia, spoon-shaped nails (koilonychia) are a common symptom due to changes in the nail bed. This condition is known as Plummer-Vinson syndrome. While fatigue and weakness are common in iron deficiency anemia, hyperactivity (choice A) is not typically associated with this condition. Gait problems (choice C) and petechiae (choice D) are more commonly seen in other medical conditions and are not characteristic of iron deficiency anemia.

4. Which of the following outcome criteria is appropriate for a client with dementia?

• A. The client will return to an established schedule for activities of daily living.
• B. The client will learn new coping mechanisms to handle anxiety.
• C. The client will seek out resources in the community for support.
• D. The client will follow an established schedule for activities of daily living.

Correct answer: D

Rationale: The correct answer is D. For clients with dementia, following an established schedule for activities of daily living is appropriate as it helps maintain routine and structure, which can be beneficial for their condition. Choice A has been rephrased to align better with the context of dementia care. Choice A is incorrect as expecting a return to a previous level of self-functioning may not be realistic for clients with dementia. Choice B is not the most appropriate outcome criteria as handling anxiety, while important, may not be the primary focus when working with clients with dementia. Choice C, seeking out resources in the community for support, is also important but may not be as directly related to the day-to-day care and management of activities for a client with dementia.

5. When a healthcare professional is reviewing lab results and notices that the erythrocytes contain an abnormally low concentration of hemoglobin, the healthcare professional calls these erythrocytes:

• A. Hyperchromic
• B. Hypochromic
• C. Macrocytic
• D. Microcytic

Correct answer: B

Rationale: Erythrocytes with an abnormally low concentration of hemoglobin are called hypochromic. Hyperchromic refers to erythrocytes with an abnormally high concentration of hemoglobin. Macrocytic indicates larger than normal red blood cells, while microcytic refers to smaller than normal red blood cells. Therefore, in this scenario, the correct term is hypochromic.

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