Nursing Elites

1. Which of the following is a key symptom of myocardial infarction (MI)?

• A. Chest pain.
• B. Shortness of breath.
• C. Nausea.
• D. Fatigue.

Correct answer: A

Rationale: The correct answer is A: Chest pain. Chest pain is a hallmark symptom of myocardial infarction (MI) due to inadequate blood flow to the heart muscle. This pain can be severe, crushing, or squeezing, and may radiate to the left arm, jaw, or back. Shortness of breath (choice B), nausea (choice C), and fatigue (choice D) can accompany MI but are not as specific or characteristic as chest pain in diagnosing this condition. Therefore, chest pain is the primary symptom to recognize for suspected MI.

2. Which electrolyte imbalance is most likely to be seen in a patient with chronic kidney disease?

• A. Hypernatremia.
• B. Hyperkalemia.
• C. Hypocalcemia.
• D. Hypokalemia.

Correct answer: B

Rationale: In chronic kidney disease, hyperkalemia is the most common electrolyte imbalance due to the kidneys' reduced ability to excrete potassium. This impaired kidney function leads to potassium retention in the body, resulting in elevated serum potassium levels. Hypernatremia (increased sodium levels) is less likely in chronic kidney disease as the kidneys typically still function to regulate sodium levels. Hypocalcemia (low calcium levels) is not a prominent electrolyte imbalance in chronic kidney disease unless there are additional factors involved. Hypokalemia (low potassium levels) is less common in chronic kidney disease, as the primary issue is usually potassium retention rather than deficiency.

3. The nurse empties the nasogastric suction collection canister of a client who had a bowel resection the previous day and notes that 1000 ml of gastric secretions were collected in the last 4 hours. What condition is the client at risk for developing?

• A. Metabolic alkalosis
• B. Hyperkalemia
• C. Metabolic acidosis
• D. Hypoglycemia

Correct answer: A

Rationale: The correct answer is A: Metabolic alkalosis. Loss of gastric secretions, which contain stomach acid, can lead to metabolic alkalosis. Excessive loss of acid results in an increase in the blood pH, leading to alkalosis. Hyperkalemia (B) is an elevated potassium level and is not directly related to the loss of gastric secretions. Metabolic acidosis (C) is an acid-base imbalance characterized by low pH and bicarbonate levels, which is the opposite of what would occur with the loss of gastric secretions. Hypoglycemia (D) is low blood sugar and is not typically associated with the scenario described in the question.

4. A client's laboratory findings indicate elevations in thyroxine and triiodothyronine hormones. The nurse suspects that the client may have hyperthyroidism. Which assessment finding is most often associated with hyperthyroidism?

• A. Periorbital edema.
• B. Atrophied thyroid gland.
• C. Increased pulse rate.
• D. Diarrhea stools.

Correct answer: C

Rationale: Increased pulse rate is commonly associated with hyperthyroidism due to the increased metabolic rate. Periorbital edema (Choice A) is more commonly associated with conditions like nephrotic syndrome or heart failure, not hyperthyroidism. Atrophied thyroid gland (Choice B) is not typically an assessment finding for hyperthyroidism as the gland is usually enlarged in this condition. Diarrhea stools (Choice D) can occur in hyperthyroidism, but it is not the most common assessment finding associated with the condition.

5. A client has just had a central line catheter placed that is specific for hemodialysis. What is the most appropriate action by the nurse?

• A. Use the catheter for the next laboratory blood draw.
• B. Monitor the central venous pressure through this line.
• C. Access the line for the next intravenous medication.
• D. Place a heparin or heparin/saline dwell after hemodialysis.

Correct answer: D

Rationale: The most appropriate action for the nurse after a central line catheter placement for hemodialysis is to place a heparin or heparin/saline dwell after hemodialysis treatment. This helps prevent clot formation in the line and maintain patency for future use. Using the catheter for blood draws is not recommended as it may increase the risk of infection. Monitoring central venous pressure is not indicated with this type of catheter. Accessing the line for medications is also not recommended to prevent complications and ensure the line is solely used for hemodialysis purposes.

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