RN Registered Nurse 5 — Questions and Answers
Question 1: A patient with chronic kidney disease (CKD) is at risk for hyperkalemia. Which food should the nurse instruct the patient to avoid?
- White rice and pasta
- Bananas and oranges (Correct answer)
- Whole wheat bread
- Chicken breast and turkey
Correct answer: Bananas and oranges
Bananas and oranges are high-potassium foods that can worsen hyperkalemia in CKD patients whose kidneys cannot excrete excess potassium.
Question 2: A nurse is caring for a patient in alcohol withdrawal. Which medication does the nurse anticipate the provider will order to prevent seizures?
- Haloperidol
- Naloxone
- Lorazepam (Correct answer)
- Methadone
Correct answer: Lorazepam
Benzodiazepines such as lorazepam are the first-line treatment for alcohol withdrawal because they cross-react with GABA receptors and prevent withdrawal seizures.
Question 3: A nurse is caring for a patient with a chest tube connected to water-seal drainage. The nurse observes continuous bubbling in the water-seal chamber. What does this indicate?
- Normal functioning of the drainage system
- Air leak in the system or lung (Correct answer)
- Excessive fluid drainage
- The tube is kinked and needs repositioning
Correct answer: Air leak in the system or lung
Continuous (not intermittent) bubbling in the water-seal chamber indicates an air leak from either the patient's lung or the drainage system connections.
Question 4: A patient with heart failure is prescribed furosemide 40 mg IV. Which laboratory value should the nurse assess before and after administration?
- Serum calcium
- Serum potassium (Correct answer)
- Serum sodium
- Blood glucose
Correct answer: Serum potassium
Furosemide is a loop diuretic that causes significant potassium wasting; hypokalemia can lead to dangerous cardiac dysrhythmias.
Question 5: A nurse is providing discharge teaching to a patient prescribed warfarin. Which statement by the patient indicates a need for further teaching?
- 'I will have my INR checked regularly at the lab.'
- 'I will take ibuprofen instead of acetaminophen for pain.' (Correct answer)
- 'I will report any unusual bruising or bleeding to my doctor.'
- 'I will avoid making major changes to my diet without consulting my provider.'
Correct answer: 'I will take ibuprofen instead of acetaminophen for pain.'
NSAIDs like ibuprofen inhibit platelet aggregation and displace warfarin from protein-binding sites, significantly increasing bleeding risk.
Question 6: A nurse is assessing a patient who has been in a house fire. The patient's lips appear cherry-red. Which condition does the nurse suspect?
- Cyanide poisoning
- Carbon monoxide poisoning (Correct answer)
- Thermal airway burn
- Methemoglobinemia
Correct answer: Carbon monoxide poisoning
Cherry-red skin and mucous membranes are a classic sign of carbon monoxide poisoning because carboxyhemoglobin gives blood a bright red color.
Question 7: A postpartum patient develops a fever of 100.8°F (38.2°C) on day 3 after a vaginal delivery. Which assessment finding is most concerning for endometritis?
- Lochia rubra with a fleshy odor
- Uterine fundus midline and firm at the umbilicus
- Foul-smelling lochia with uterine tenderness on palpation (Correct answer)
- Mild breast engorgement with clear colostrum
Correct answer: Foul-smelling lochia with uterine tenderness on palpation
Foul-smelling lochia combined with uterine tenderness and fever after delivery are hallmark signs of endometritis, a uterine infection requiring antibiotic treatment.
RN Registered Nurse 5
A patient with chronic kidney disease (CKD) is at risk for hyperkalemia.
Which food should the nurse instruct the patient to avoid?