Nokea
Which of the following electrolyte imbalances is likely to result in a shortened QT interval?
- A. Hypercalcemia
- B. Hyponatremia
- C. Hypomagnesemia
- D. Hyperphosphatemia
Correct Answer: A
Rationale: Hypercalcemia shortens the QT interval on an ECG by accelerating cardiac repolarization. Hyponatremia hypomagnesemia and hyperphosphatemia are more likely to prolong the QT interval or have other ECG effects.
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A client has been admitted to the nursing unit with the diagnosis of severe anemia. She is slightly short of breath, has episodes of dizziness, and complains her heart sometimes feels like it will 'beat out of her chest.' The physician has ordered her to receive 2 U of packed red blood cells. The most important nursing action to be taken is:
- A. Starting an 18-gauge IV infusion
- B. Having the consent form on the chart
- C. Administering the correct blood product to the correct client
- D. Transfusing the blood in a 2-hour time frame
Correct Answer: C
Rationale: An 18-gauge IV is an appropriate size for administering blood; however, client safety demands that the right blood product must be administered. The consent form is legally necessary to be on the chart, but client safety is maintained by giving the correct blood component to the correct client. Administering the correct blood product to the correct client will maintain physiological safety and minimize transfusion reactions. The blood administration should take place over the ordered time frame designated by the physician.
A client with a history of Parkinson’s disease is prescribed levodopa/carbidopa (Sinemet). Which statement by the client indicates a need for further teaching?
- A. "I will take this medication with meals to reduce nausea."
- B. "I should report muscle twitching to my doctor."
- C. "I can stop this medication if my symptoms improve."
- D. "I will avoid high-protein meals with this medication."
Correct Answer: C
Rationale: Stopping levodopa/carbidopa abruptly (C) can worsen Parkinson’s symptoms, indicating a need for further teaching. Taking with meals (A), reporting twitching (B), and avoiding protein (D) are correct.
A 24-year-old client presents to the emergency department protesting 'I am God.' The nurse identifies this as a:
- A. Delusion
- B. Illusion
- C. Hallucination
- D. Conversion
Correct Answer: A
Rationale: A delusion is a false belief, such as claiming to be God, common in psychotic disorders.
The nurse is caring for a client with a diagnosis of abruptio placenta. Which nursing intervention is most appropriate?
- A. Monitor fetal heart tones
- B. Administer oxygen at 2 liters per minute
- C. Place the client in Trendelenburg position
- D. Increase IV fluid rate
Correct Answer: A
Rationale: Abruptio placenta can cause fetal hypoxia making monitoring fetal heart tones the most appropriate intervention to assess fetal well-being. Oxygen Trendelenburg and fluids are secondary based on clinical findings.
A client presented herself to the mental health center, describing the following symptoms: a weight loss of 20 lb in the past 2 months, difficulty concentrating, repeated absences from work due to 'fatigue,' and not wanting to get dressed in the morning. She leaves her recorded message on her telephone and has lost interest in answering the phone or doorbell. The nurse's assessment of her behavior would most likely be:
- A. Deep depression
- B. Psychotic depression
- C. Severe anxiety
- D. Severe depression
Correct Answer: D
Rationale: Although the client was able to bring herself to the mental health center, the extent of her weight loss and the interference of symptoms with activities of daily living indicate that she is severely depressed.