Nursing Elites

1. Which manifestation should the nurse expect to assess in a patient with fluid volume deficit?

• A. Headache and muscle cramps
• B. Dyspnea and respiratory crackles
• C. Increased pulse rate and blood pressure
• D. Orthostatic hypotension and flat neck veins

Correct answer: D

Rationale: Orthostatic hypotension and flat neck veins are classic manifestations of fluid volume deficit. When the body loses fluid, blood volume decreases, leading to decreased venous return to the heart, resulting in orthostatic hypotension and flat neck veins. Choices A, B, and C are more indicative of other conditions such as dehydration, respiratory issues, or compensatory mechanisms in response to hypovolemia, respectively.

2. A client with diabetes experiences Somogyi's effect. To prevent this complication, the nurse should instruct the client to:

• A. Take insulin at 2:00 PM each day
• B. Engage in physical activity daily
• C. Increase the dose of regular insulin
• D. Eat a protein and carbohydrate snack at bedtime

Correct answer: D

Rationale: Somogyi effect, also known as rebound hyperglycemia, occurs as a response to nighttime hypoglycemia. Eating a protein and carbohydrate snack at bedtime can help prevent this by stabilizing blood sugar levels throughout the night. Instructing the client to take insulin at 2:00 PM each day (Choice A) may not directly address the nighttime hypoglycemia concern. Engaging in physical activity daily (Choice B) is generally beneficial for diabetes management but may not specifically prevent Somogyi's effect. Increasing the dose of regular insulin (Choice C) without addressing the nighttime hypoglycemia issue can exacerbate the problem.

3. The doctor has ordered 500 mg of a medication PO once a day. The tablets on hand are labeled as 1 tablet = 250 mg. How many tablets will you administer to your patient?

• A. 1 Tablet
• B. 2 Tablets
• C. 3 Tablets
• D. 4 Tablets

Correct answer: B

Rationale: To calculate the number of tablets needed, divide the total dosage prescribed (500 mg) by the dosage per tablet (250 mg per tablet). 500 mg / 250 mg per tablet = 2 tablets. Therefore, the correct answer is 2 tablets. Choices A, C, and D are incorrect as they do not accurately reflect the correct calculation based on the provided information.

4. A nurse caring for a group of clients reviews the electrolyte laboratory results and notes a sodium level of 130 mEq/L on one client's laboratory report. The nurse understands that which client is at highest risk for the development of a sodium value at this level?

• A. The client with renal failure
• B. The client who is taking diuretics
• C. The client with hyperaldosteronism
• D. The client who is taking corticosteroids

Correct answer: B

Rationale: The correct answer is B. Clients taking diuretics are at risk for hyponatremia due to excessive sodium loss. In this scenario, a sodium level of 130 mEq/L indicates hyponatremia, which is commonly associated with diuretic use. Options A, C, and D are not the highest risk factors for developing low sodium levels in this context. Renal failure, hyperaldosteronism, and corticosteroid use are not directly linked to sodium loss as seen with diuretics.

5. What is the primary focus of primary healthcare?

• A. Emergency care
• B. Preventive care
• C. Specialized treatment
• D. Hospital-based services

Correct answer: B

Rationale: The correct answer is B: Preventive care. Primary healthcare emphasizes preventive care, which includes promoting overall health, preventing diseases, and providing early intervention to avoid the progression of illnesses. Emergency care (choice A) is focused on immediate medical attention for urgent health situations but is not the primary focus of primary healthcare. Specialized treatment (choice C) refers to care provided by specialists for specific health conditions, which is not the main focus of primary healthcare. Hospital-based services (choice D) involve inpatient care provided in a hospital setting, which is not the primary focus of primary healthcare that aims to provide comprehensive and accessible care at the community level.

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