Nursing Elites

1. Which technique or method is used to determine whether or not the patient has an irregular pulse?

• A. Apical pulse
• B. Inspection
• C. Auscultation
• D. Percussion

Correct answer: A

Rationale: An apical pulse check is used to determine if the patient has an irregular pulse. The apical pulse is located at the point of maximal impulse (PMI) and is assessed using a stethoscope. Choice B, inspection, involves visual examination and is not used to assess pulse irregularities. Choice C, auscultation, involves listening to internal sounds using a stethoscope, which can be used to assess heart sounds but not specifically for pulse irregularities. Choice D, percussion, is a technique used to assess the density of body tissues or detect abnormal masses and is not used to determine pulse irregularities.

2. Based on the signs and symptoms of erythema marginatum, Sydenham chorea, epistaxis, abdominal pain, fever, cardiac problems, and skin nodules in your 32-year-old female patient, what disorder would you most likely suspect?

• A. Leukemia
• B. Histoplasmosis
• C. Pneumocystis jiroveci
• D. Rheumatoid arthritis

Correct answer: D

Rationale: The signs and symptoms described point towards rheumatoid arthritis. Erythema marginatum, Sydenham chorea, epistaxis, abdominal pain, fever, cardiac issues, and skin nodules are classic manifestations of rheumatic fever, which is a complication of untreated streptococcal infection. This condition can lead to rheumatoid arthritis over time. Choices A, B, and C are incorrect as they do not align with the provided signs and symptoms, and they are not associated with the clinical presentation described.

3. Insulin forces which of the following electrolytes out of the plasma and into the cells?

• A. Calcium
• B. Magnesium
• C. Phosphorus
• D. Potassium

Correct answer: D

Rationale: Insulin forces potassium out of the plasma and into the cells, which can cause hypokalemia. This is because insulin enhances the activity of the sodium-potassium pump in cell membranes, promoting the movement of potassium from the extracellular fluid into the cells. Choices A, B, and C are incorrect as insulin does not directly influence the movement of calcium, magnesium, or phosphorus in the same manner as it does with potassium.

4. Select the type of skeletal fracture that is correctly paired with its description.

• A. A complete fracture: The fractured bone penetrates through the skin to the skin surface.
• B. A pathological fracture: A fracture that results from some physical trauma.
• C. A greenstick fracture: This bends but does not fracture the bone.
• D. An avulsion fracture: A fracture that pulls a part of the bone from the tendon or ligament

Correct answer: D

Rationale: The correct answer is D. An avulsion fracture occurs when a part of the bone is pulled away by a tendon or ligament. Choice A is incorrect because it describes an open fracture where the bone penetrates the skin. Choice B is incorrect as a pathological fracture results from an underlying disease weakening the bone, not physical trauma. Choice C is incorrect as a greenstick fracture involves the bone bending but not completely breaking.

5. A nurse reviews a client's laboratory report and notes that the client's serum phosphorus level is 2.0 mg/dL. Which condition most likely caused this serum phosphorus level?

• A. Alcoholism
• B. Renal insufficiency
• C. Hypoparathyroidism
• D. Tumor lysis syndrome

Correct answer: A

Rationale: The correct answer is A: Alcoholism. Alcoholism can lead to hypophosphatemia due to poor dietary intake and other factors. Excessive alcohol consumption can result in malnutrition, particularly a deficiency in phosphorus. Choices B, C, and D are unlikely to cause low serum phosphorus levels. Renal insufficiency is more likely to cause hyperphosphatemia, hypoparathyroidism is associated with hypocalcemia rather than hypophosphatemia, and tumor lysis syndrome typically presents with hyperphosphatemia due to the release of intracellular phosphate.

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