Nursing Elites

1. A client is at risk for excess fluid volume. Which nursing intervention ensures the most accurate monitoring of the client’s fluid status?

• A. Measuring and recording fluid intake and output
• B. Weighing the client daily at the same time each day
• C. Assessing the client’s vital signs every 4 hours
• D. Checking the client’s lungs for crackles during every shift

Correct answer: B

Rationale: Weighing the client daily at the same time each day is the most accurate method for monitoring fluid balance. Changes in body weight can reflect fluid retention or loss. Measuring and recording fluid intake and output (Choice A) is important but may not provide immediate changes in fluid status. Assessing vital signs (Choice C) can offer some information but may not be as specific to fluid status as daily weighing. Checking the client's lungs for crackles (Choice D) is more related to assessing respiratory status rather than direct fluid monitoring.

2. Which drugs contribute to peptic ulcers?

• A. Antacids
• B. Certain antibiotics
• C. Cholesterol-lowering medications
• D. Nonsteroidal anti-inflammatory drugs

Correct answer: D

Rationale: Nonsteroidal anti-inflammatory drugs (NSAIDs) are known to contribute to the development of peptic ulcers by affecting the protective lining of the stomach and increasing stomach acid production. This can lead to irritation and ulcer formation. Antacids are actually used to relieve symptoms of peptic ulcers by neutralizing stomach acid. Certain antibiotics may be prescribed to treat H. pylori infection, a common cause of peptic ulcers. Cholesterol-lowering medications are not typically associated with causing peptic ulcers.

3. A client who _____ diet requires _____ amounts of vitamin C.

• A. Follows a vegan diet
• B. Smokes cigarettes
• C. Follows a ketogenic diet
• D. Is lactose intolerant

Correct answer: B

Rationale: Clients who smoke require more vitamin C due to increased oxidative stress and depletion of vitamin C. Smoking leads to higher levels of oxidative stress in the body, which in turn increases the utilization of vitamin C to counteract the damage caused by free radicals. Choices A, C, and D do not directly impact the body's need for vitamin C as smoking does.

4. The nurse is preparing to assist in examining a Hispanic child who was brought to the clinic by the mother. During the assessment of the child, the nurse should take which action(s)?

• A. Admiring the child
• B. Taking the child’s temperature
• C. A, D
• D. Obtaining an interpreter if necessary

Correct answer: C

Rationale: In a multicultural healthcare setting, it's essential for the nurse to build rapport with the child and family. Admiring the child can help establish trust and comfort. Additionally, since the child's mother brought them to the clinic, it's crucial to ensure effective communication. Obtaining an interpreter, if necessary, is vital for clear and accurate information exchange. Taking the child's temperature, while important in a physical assessment, is not specifically highlighted in this scenario. Therefore, choices A and B alone are not sufficient, making the correct answer C, which includes both building rapport by admiring the child and ensuring clear communication by obtaining an interpreter if needed.

5. Which laboratory data indicate the client’s pancreatitis is improving?

• A. The amylase and lipase serum levels are decreased
• B. The white blood cell count (WBC) is decreased
• C. The conjugated and unconjugated bilirubin levels are decreased
• D. The blood urea nitrogen (BUN) serum level is decreased

Correct answer: A

Rationale: The correct answer is A. Amylase and lipase are enzymes specifically related to pancreatitis. A decrease in their serum levels indicates improvement in pancreatitis. White blood cell count (WBC), choices C and D, are not direct markers for pancreatitis improvement. Bilirubin levels, choice C, are more related to liver function rather than pancreatitis. Blood urea nitrogen (BUN) level, choice D, is a marker for kidney function, not pancreatitis.

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