Nursing Elites

1. Which electrolyte imbalance is most concerning for a patient on furosemide?

• A. Hypokalemia
• B. Hyponatremia
• C. Hyperkalemia
• D. Hypercalcemia

Correct answer: A

Rationale: The correct answer is hypokalemia. Furosemide, a loop diuretic, can lead to potassium loss through increased urinary excretion, making hypokalemia the most concerning electrolyte imbalance. Hyponatremia (Choice B) is not typically associated with furosemide use. Hyperkalemia (Choice C) is less likely due to furosemide's potassium-wasting effect. Hypercalcemia (Choice D) is not a common electrolyte imbalance seen with furosemide.

2. A client with diabetes mellitus is receiving teaching from a nurse about foot care. Which of the following instructions should the nurse include?

• A. Soak your feet in warm water daily.
• B. Wear cotton socks.
• C. Use a heating pad to warm your feet.
• D. Trim toenails straight across.

Correct answer: D

Rationale: The correct answer is to trim toenails straight across. This instruction is crucial for clients with diabetes to prevent ingrown toenails, which can lead to infection. Soaking feet in warm water daily can increase the risk of skin breakdown. Cotton socks are recommended, but the priority in foot care for diabetes is proper nail trimming. Using a heating pad can also pose a burn risk for individuals with reduced sensation in their feet.

3. A nurse is preparing to administer an IV bolus of 0.9% sodium chloride to a client who is dehydrated. Which of the following actions should the nurse take?

• A. Administer the solution slowly over 24 hours
• B. Assess the client's lung sounds before administration
• C. Change the IV tubing every 12 hours
• D. Flush the IV line with 2 mL of heparin every 4 hours

Correct answer: B

Rationale: The correct action for the nurse to take is to assess the client's lung sounds before administering IV fluids. This is crucial to identify any signs of fluid overload, such as crackles or wheezes. Administering the solution slowly over 24 hours (choice A) is not appropriate for an IV bolus, which is a rapid infusion. Changing the IV tubing every 12 hours (choice C) is a standard practice for preventing infection but is not directly related to administering an IV bolus. Flushing the IV line with heparin every 4 hours (choice D) is a maintenance practice to prevent clot formation in the line, not specifically related to administering an IV bolus.

4. A nurse is providing teaching about digoxin administration to the parents of a toddler with heart failure. Which of the following statements should the nurse include?

• A. Limit your child's potassium intake while taking this medication.
• B. You can mix the medication with a half-cup of your child's favorite juice.
• C. Do not repeat the dose if your child vomits within one hour after taking the medication.
• D. Have your child drink a small glass of water after swallowing the medication.

Correct answer: D

Rationale: The correct statement to include in the teaching about digoxin administration is to have the child drink a small glass of water after swallowing the medication. Water helps flush down the medication, preventing irritation in the esophagus. Choice A is incorrect because digoxin may interact with potassium levels, but strict restriction is not necessary. Choice B is incorrect as medications should not be mixed with juices unless specified by the healthcare provider due to possible interactions. Choice C is incorrect because if a child vomits after taking digoxin, the dose should not be repeated to avoid double dosing.

5. A nurse is providing teaching to a client who is receiving radiation therapy for cancer of the larynx. Which of the following instructions should the nurse include?

• A. Apply heat to the neck to relieve pain.
• B. Use a soft-bristle toothbrush to prevent gum irritation.
• C. Rinse your mouth with an alcohol-free mouthwash twice daily.
• D. Wear loose-fitting clothing to protect your skin.

Correct answer: B

Rationale: The correct answer is to use a soft-bristle toothbrush to prevent gum irritation in clients undergoing radiation therapy for laryngeal cancer. Radiation therapy can cause oral mucositis and increase the risk of gum irritation, so using a soft-bristle toothbrush is recommended to minimize trauma to the gums and oral mucosa. Applying heat to the neck is contraindicated as it can exacerbate tissue damage caused by radiation. Rinsing the mouth with an alcohol-free mouthwash is preferred over an alcohol-based one to prevent drying and irritation of the oral mucosa. Wearing loose-fitting clothing is advised to prevent friction and irritation on the skin, rather than tight-fitting clothing that may cause pressure ulcers or skin breakdown.

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