Nursing Elites

1. A patient is admitted to the emergency room and is found to have proteinuria, a low serum albumin level, edema, and elevated blood lipids. Which condition do these symptoms typically associate with?

• A. Nephrotic syndrome
• B. Acute kidney injury
• C. Rejection of a kidney transplant
• D. Renal colic

Correct answer: A

Rationale: The correct answer is A: Nephrotic syndrome. Nephrotic syndrome is characterized by proteinuria (excess protein in urine), hypoalbuminemia (low serum albumin), edema (swelling due to fluid buildup), and hyperlipidemia (elevated blood lipids). These symptoms occur as a result of damage to the kidneys' filtering units. Acute kidney injury, rejection of a kidney transplant, and renal colic do not present with the same combination of symptoms as nephrotic syndrome. Acute kidney injury typically presents with a sudden decrease in kidney function, resulting in a build-up of waste products in the blood. Rejection of a kidney transplant may present with fever, pain at the transplant site, and changes in urine output. Renal colic usually presents with intense pain in the lower back or side, related to kidney stones.

2. You notice that Miss Kate, a bread vendor, receives and changes money, then holds the bread without washing her hands. As a nurse, what should you say to Miss Kate?

• A. Miss, don't touch the bread, I'll be the one to pick it up.
• B. Miss, please wash your hands before you pick up the bread.
• C. Miss, use a pick-up forceps when picking up the bread.
• D. Miss, your hands are dirty, I guess I'll try another bread shop.

Correct answer: B

Rationale: The correct answer is B, as it emphasizes the importance of hygiene in food handling, which is crucial to prevent the spread of germs and diseases. The other options do not address the root of the issue, which is the unhygienic handling of food. Option A avoids direct confrontation but does not educate the vendor on proper hygiene. Option C, although it suggests a hygienic method, may not be practical or available in all situations. Option D is an avoidance strategy rather than a way to address the problem.

3. Causes of acute renal failure include:

• A. chronic renal failure
• B. uncontrolled diabetes mellitus
• C. recurrent urinary tract infections
• D. severe injury such as extensive burns

Correct answer: D

Rationale: The correct answer is D. Severe injuries, like extensive burns, can cause acute renal failure due to shock, reduced blood flow to the kidneys, and tissue damage. Choices A, B, and C are incorrect because chronic renal failure, uncontrolled diabetes mellitus, and recurrent urinary tract infections are more likely to contribute to chronic kidney disease rather than acute renal failure.

4. An adolescent client has bloodshot eyes, a voracious appetite, and dry mouth. Which drug abuse would the nurse most likely suspect?

• A. Marijuana
• B. Amphetamines
• C. Barbiturates
• D. Anxiolytics

Correct answer: A

Rationale: The symptoms described, including bloodshot eyes, a voracious appetite, and dry mouth, are consistent with marijuana use. Bloodshot eyes are a common side effect of marijuana due to its effect on blood vessels in the eyes. Marijuana also often causes an increase in appetite (known as 'the munchies') and can result in dry mouth. Amphetamines typically cause symptoms like increased alertness, energy, and decreased appetite. Barbiturates and anxiolytics would not typically cause bloodshot eyes, a voracious appetite, and dry mouth as described in the scenario. Therefore, the most likely drug abuse the nurse would suspect in this case is marijuana.

5. Which nutrient is most important for maintaining fluid balance in the body?

• A. Protein
• B. Sodium
• C. Calcium
• D. Vitamin C

Correct answer: B

Rationale: Sodium plays a key role in maintaining fluid balance and regulating blood pressure.

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