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. A nurse is teaching a group of clients about stress. Which of the following should the nurse include in the teaching?

• A. Protein requirements decrease in times of stress.
• B. Acute stress causes an increase in metabolism.
• C. Stress causes a positive nitrogen balance in the body.
• D. Glucose is broken down more slowly during times of stress.

Correct answer: B

Rationale: The correct answer is B: Acute stress causes an increase in metabolism. During acute stress, the body's fight-or-flight response is activated, leading to an increase in metabolism to provide energy for the body to respond to the stressor. Choices A, C, and D are incorrect. Protein requirements actually increase during times of stress to support the body's needs. Stress typically leads to a negative nitrogen balance in the body, not a positive one. Glucose is broken down more rapidly, not slowly, during times of stress to provide immediate energy.

3. What is the primary purpose of dietary fiber in the diet?

• A. Improving digestion
• B. Providing energy
• C. Aiding in the absorption of vitamins
• D. Reducing cholesterol

Correct answer: D

Rationale: The primary purpose of dietary fiber in the diet is to reduce cholesterol levels. While it does aid in digestion by promoting regular bowel movements, its main role is in lowering cholesterol. Choice A is partially correct but not the primary purpose. Choice B is incorrect as fiber is not a direct source of energy. Choice C is also incorrect as the primary role of fiber is not in the absorption of vitamins.

4. In cleaning the stoma, the nurse would use which of the following cleaning mediums?

• A. Hydrogen Peroxide, water and mild soap
• B. Providone Iodine, water and mild soap
• C. Alcohol, water and mild soap
• D. Mild soap and water

Correct answer: D

Rationale: Understanding the underlying pathology and therapeutic techniques ensures that nursing care is not only reactive but also preventative, reducing the risk of complications.

5. A nurse is caring for a client with a major burn injury and is receiving TPN. Which of the following lab tests is the priority for the nurse to use to confirm the client is receiving adequate nutrition?

• A. Iron
• B. Magnesium
• C. Folic acid
• D. Prealbumin

Correct answer: D

Rationale: Prealbumin is a sensitive indicator of protein status and nutrition, making it a priority for assessing nutritional adequacy in clients receiving TPN. Iron, magnesium, and folic acid levels are important for overall health but do not specifically indicate nutritional adequacy in the context of TPN administration.

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