Nursing Elites

1. A client with a history of chronic renal failure is admitted with generalized edema. Which laboratory value should the LPN/LVN monitor to assess the client's fluid balance?

• A. Serum potassium
• B. Serum calcium
• C. Serum albumin
• D. Serum sodium

Correct answer: C

Rationale: The correct answer is C, Serum albumin. In clients with chronic renal failure and generalized edema, monitoring serum albumin levels is crucial as it is a key indicator of fluid balance. Low serum albumin levels can contribute to edema formation due to decreased oncotic pressure, indicating fluid imbalance. Serum potassium (Choice A) is more related to kidney function and electrolyte balance in renal failure patients. Serum calcium (Choice B) is important for bone health but is not directly related to fluid balance. Serum sodium (Choice D) is more indicative of hydration status and electrolyte balance but may not directly reflect fluid balance in the context of chronic renal failure and edema.

2. When explaining the fecal occult blood testing procedure to a client, which of the following information should be included?

• A. Eating more protein is not necessary before testing.
• B. Multiple stool specimens may be required for testing.
• C. A red color change indicates a positive test.
• D. The specimen must not be contaminated with urine.

Correct answer: D

Rationale: The correct answer is D. When performing fecal occult blood testing, it is crucial to inform the client that the specimen must not be contaminated with urine to prevent false results. Choices A and B are incorrect because eating more protein is not required before testing, and multiple stool specimens may be necessary for accurate results, respectively. Additionally, regarding choice C, a red color change, not blue, indicates a positive test result, making it an incorrect option.

3. What instruction should the nurse provide for a UAP caring for a client with MRSA who has a prescription for contact precautions?

• A. Allow visitors with precautions in place
• B. Wear sterile gloves when handling the client's body fluid
• C. Have the client wear a mask whenever someone enters the room
• D. Don a gown and gloves when entering the room

Correct answer: D

Rationale: The correct instruction for a UAP caring for a client with MRSA under contact precautions is to don a gown and gloves when entering the room. Wearing a gown and gloves is necessary to prevent the transmission of MRSA. Choice A is incorrect because visitors may be allowed with proper precautions in place. Choice B is incorrect as it assumes the client has body fluid precautions, which is not specified. Choice C is incorrect as it does not address the UAP's protective measures but rather focuses on the client wearing a mask.

4. The client is receiving discharge instructions for warfarin (Coumadin). Which statement by the client indicates a need for further teaching?

• A. I will avoid eating foods high in vitamin K.
• B. I will have my blood tested regularly to monitor my INR levels.
• C. I will take the medication at the same time every day.
• D. I will use a soft toothbrush to prevent bleeding gums.

Correct answer: A

Rationale: The correct answer is A. Clients taking warfarin need to be consistent with their vitamin K intake to maintain a balance in blood clotting. Avoiding foods high in vitamin K is essential as they can interfere with the medication's effectiveness. Choices B, C, and D are all correct statements regarding warfarin therapy. Regular blood testing to monitor INR levels ensures the medication is working effectively, taking the medication at the same time daily maintains a consistent level in the bloodstream, and using a soft toothbrush helps prevent gum bleeding due to warfarin's anticoagulant effects.

5. A client is hospitalized for an infection of a surgical wound following abdominal surgery. To promote healing and fight wound infection, the nurse plans to arrange to increase the client's intake of:

• A. Vitamin C and Zinc
• B. Vitamin B12 and Calcium
• C. Vitamin D and Iron
• D. Vitamin A and Potassium

Correct answer: A

Rationale: The correct answer is A: Vitamin C and Zinc. Vitamin C is essential for collagen synthesis, which is important for wound healing. Zinc plays a crucial role in immune function and also aids in wound healing. Vitamin B12 and Calcium (Choice B) are not directly associated with wound healing properties. Vitamin D and Iron (Choice C) are important for overall health but are not specifically targeted for wound healing. Vitamin A and Potassium (Choice D) do not have direct wound healing properties and are not the best choices to promote wound healing and fight infection.

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