Nursing Elites

1. Your patient has a blood potassium level of 9.2 mEq/L. What intervention should you anticipate for this patient?

• A. Intravenous potassium supplementation
• B. Intravenous calcium supplementation
• C. Kidney dialysis
• D. Parenteral nutrition

Correct answer: C

Rationale: The correct answer is C: Kidney dialysis. A blood potassium level of 9.2 mEq/L indicates severe hyperkalemia, which can be life-threatening. Kidney dialysis is the most appropriate intervention to rapidly lower potassium levels in this situation. Choice A, intravenous potassium supplementation, would worsen the hyperkalemia. Choice B, intravenous calcium supplementation, is not the primary intervention for hyperkalemia. Choice D, parenteral nutrition, is unrelated to treating hyperkalemia and would not address the immediate concern.

2. A client is in DKA, secondary to infection. As the condition progresses, which of the following symptoms might the nurse see?

• A. Kussmaul's respirations and a fruity odor on the breath
• B. Shallow respirations and severe abdominal pain
• C. Decreased respirations and increased urine output
• D. Cheyne-Stokes respirations and foul-smelling urine

Correct answer: A

Rationale: In diabetic ketoacidosis (DKA), as the condition progresses, the body tries to compensate for the acidic environment by increasing the respiratory rate, leading to Kussmaul's respirations. The accumulation of ketones in the body causes a fruity odor on the breath. Option A is correct because Kussmaul's respirations and a fruity odor on the breath are classic signs of DKA. Option B is incorrect because shallow respirations are not typically seen in DKA, and severe abdominal pain is more commonly associated with conditions like pancreatitis. Option C is incorrect as decreased respirations are not a typical finding in DKA, and increased urine output is more commonly seen in conditions like diabetes insipidus. Option D is incorrect because Cheyne-Stokes respirations are not characteristic of DKA, and foul-smelling urine is not a prominent symptom in this condition.

3. Your long-term care patient has chronic pain and at this point in time, the patient needs increasing dosages to adequately control this pain. What is this patient most likely affected by?

• A. Drug addiction
• B. Drug interactions
• C. Drug side effects
• D. Drug tolerance

Correct answer: D

Rationale: The correct answer is D: Drug tolerance. When a patient needs increasing dosages to achieve the same pain relief, it indicates the development of drug tolerance. This means the body has adapted to the drug, requiring higher doses to produce the same effect. Choice A, drug addiction, is incorrect because drug addiction involves a psychological and physical dependence on the drug, which is not described in the scenario. Choice B, drug interactions, is incorrect as it refers to the effects when multiple drugs interact with each other, not the situation described. Choice C, drug side effects, is also incorrect as it pertains to the unintended effects of a drug, not the need for higher doses to control pain.

4. Diabetes insipidus is the result of:

• A. A diet high in sugar and carbohydrates.
• B. A complicated pregnancy.
• C. A disorder of the pancreas.
• D. A disorder of the pituitary gland.

Correct answer: D

Rationale: Diabetes insipidus is caused by a disorder of the pituitary gland affecting ADH regulation. This disorder results in the decreased production or release of antidiuretic hormone (ADH), leading to the inability of the kidneys to concentrate urine properly. Choices A, B, and C are incorrect as they do not relate to the underlying cause of diabetes insipidus.

5. Which statement about adjuvant medications is true and accurate?

• A. Licensed practical nurses can administer adjuvant medications.
• B. Adjuvant medications are schedule 2 narcotics.
• C. Adjuvant medications are schedule 1 narcotics.
• D. Adjuvant medications can be purchased over the counter.

Correct answer: D

Rationale: The correct answer is D because adjuvant medications are often available over the counter without a prescription. Choices A, B, and C are incorrect. Choice A is incorrect because licensed practical nurses can administer adjuvant medications depending on their scope of practice. Choices B and C are incorrect because adjuvant medications are not classified as schedule 1 or schedule 2 narcotics.

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