Nursing Elites

1. Which of the following arterial blood gas values indicates a patient may be experiencing a condition of metabolic acidosis?

• A. PaO2 90 mm Hg
• B. Bicarbonate 15 mEq/L
• C. CO2 47 mm Hg
• D. pH 7.34

Correct answer: B

Rationale: The correct answer is B: Bicarbonate 15 mEq/L. In metabolic acidosis, the bicarbonate levels are lower than normal. A bicarbonate value of 15 mEq/L indicates a deficit in the buffer system, contributing to the acidosis. Choices A, C, and D are incorrect. Choice A, PaO2 90 mm Hg, reflects oxygen partial pressure and is not directly related to metabolic acidosis. Choice C, CO2 47 mm Hg, represents carbon dioxide levels and is more indicative of respiratory status. Choice D, pH 7.34, falls within the normal range (7.35-7.45) and does not confirm metabolic acidosis.

2. In Parkinson's disease, a client's difficulty in performing voluntary movements is known as:

• A. Akinesia.
• B. Dyskinesia.
• C. Chorea.
• D. Dystonia.

Correct answer: C.

Rationale: In Parkinson's disease, the client's difficulty in performing voluntary movements is termed dyskinesia. Dyskinesia refers to the impairment of the ability to execute voluntary muscle movements. Akinesia, on the other hand, refers to the absence or lack of voluntary movement. Chorea is characterized by involuntary, rapid, irregular movements. Dystonia involves sustained muscle contractions resulting in abnormal postures or twisting movements. Therefore, dyskinesia is the specific term used for the described difficulty in Parkinson's disease.

3. Acyclovir is the drug of choice for:

• A. HIV
• B. HSV 1 and 2 and VZV
• C. CMV
• D. influenza A viruses

Correct answer: C

Rationale: Acyclovir (Zovirax) is specifically used to treat infections caused by herpes simplex virus types 1 and 2 (HSV-1 and HSV-2) and varicella-zoster virus (VZV). These include conditions like cold sores, genital herpes, and shingles. Acyclovir works by inhibiting viral DNA replication, leading to the formation of shorter, ineffective DNA chains. It is important to note that acyclovir is not effective against other viruses like HIV, cytomegalovirus (CMV), or influenza A viruses. Therefore, the correct answer is HSV 1 and 2 and VZV.

4. A client is admitted to telemetry with a diagnosis of diabetes at 3pm. At 10pm, the client is unresponsive. BP is 98/64, Resp 38, HR 100, T 97. The nurse notes a fruity smell on the client's breath. The nurse recognizes that the client is in which acid-base imbalance?

• A. Respiratory acidosis
• B. Respiratory alkalosis
• C. Metabolic acidosis
• D. Metabolic alkalosis

Correct answer: C

Rationale: Based on the client's unresponsiveness, fruity breath smell, and the presence of diabetes, the nurse can infer that the client is experiencing diabetic ketoacidosis (DKA). DKA is a complication of diabetes characterized by the accumulation of ketones in the body, leading to metabolic acidosis. The fruity breath smell is due to the presence of ketones. Therefore, the correct acid-base imbalance in this scenario is metabolic acidosis. Choice A, respiratory acidosis, is incorrect because the scenario does not provide evidence of primary respiratory dysfunction. Choice B, respiratory alkalosis, is incorrect as the client's condition does not align with the typical causes and symptoms of respiratory alkalosis. Choice D, metabolic alkalosis, is incorrect as the symptoms and history provided do not suggest a state of metabolic alkalosis.

5. What essential assessment must be performed for clients with implanted dialysis access devices?

• A. Color and capillary refill
• B. Patency and pulse
• C. Thrill and bruit
• D. Trousseau's and temperature

Correct answer: C

Rationale: Correct! When assessing clients with implanted dialysis access devices, it is crucial to palpate for the thrill, which indicates blood flow, and auscultate for the bruit, a humming sound, to ensure the patency of the access device. Choices A, B, and D are incorrect as they are not specific assessments related to dialysis access devices. Checking color and capillary refill, pulse, Trousseau's sign, and temperature are important assessments in other contexts but not specifically for monitoring implanted dialysis access devices.

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