Nursing Elites

1. A client with cirrhosis is receiving spironolactone. What electrolyte level should the nurse monitor closely?

• A. Monitor potassium levels.
• B. Monitor sodium levels.
• C. Monitor calcium levels.
• D. Monitor magnesium levels.

Correct answer: A

Rationale: The correct answer is to monitor potassium levels. Spironolactone is a potassium-sparing diuretic, which means it helps the body retain potassium and excrete sodium. Monitoring potassium levels closely is essential because spironolactone can cause hyperkalemia (high potassium levels). Sodium levels are not typically affected by spironolactone. Calcium and magnesium levels are also not directly impacted by spironolactone, making choices B, C, and D incorrect.

2. The nurse is providing care for a client receiving total parenteral nutrition (TPN). Which action should the nurse include in the client's plan of care?

• A. Increase the TPN infusion rate if the client is hungry
• B. Administer TPN via a peripheral IV line
• C. Monitor blood glucose levels regularly
• D. Ensure the TPN solution is refrigerated at all times

Correct answer: C

Rationale: The correct action the nurse should include in the client's plan of care is to monitor blood glucose levels regularly. Clients receiving TPN are at risk for hyperglycemia due to the high glucose content of the solution. Regular monitoring of blood glucose levels is essential to ensure appropriate management of blood sugar. Choice A is incorrect because increasing the TPN infusion rate based on hunger is not a valid parameter for adjusting TPN. Choice B is incorrect because TPN should be administered through a central line, not a peripheral IV line, to prevent complications. Choice D is incorrect because TPN solutions should be stored at room temperature, not refrigerated.

3. A client is receiving external beam radiation to the mediastinum for treatment of bronchial cancer. Which of the following should take priority in planning care?

• A. Esophagitis
• B. Leukopenia
• C. Fatigue
• D. Skin irritation

Correct answer: B

Rationale: The correct answer is B: Leukopenia. Leukopenia, or a low white blood cell count, is a critical concern in clients undergoing radiation therapy due to the increased risk of infection. While esophagitis, fatigue, and skin irritation are also potential side effects of radiation therapy, leukopenia poses a higher risk as it compromises the body's ability to fight infections effectively.

4. A client with chronic kidney disease is admitted with complaints of fatigue and swelling in the lower extremities. What laboratory finding is most important for the nurse to report?

• A. Serum creatinine level of 2.0 mg/dL.
• B. Hemoglobin level of 8 g/dL.
• C. Potassium level of 5.6 mEq/L.
• D. Blood urea nitrogen (BUN) level of 25 mg/dL.

Correct answer: B

Rationale: The correct answer is B. A hemoglobin level of 8 g/dL suggests anemia, which commonly occurs in clients with chronic kidney disease and requires prompt intervention. Reporting this finding is crucial to address the anemic condition. Choices A, C, and D are important in the context of chronic kidney disease but do not directly relate to the symptoms of fatigue and swelling in the lower extremities described in the scenario.

5. A client with a urinary tract infection is prescribed ciprofloxacin. What is the most important teaching the nurse should provide?

• A. Take the medication with milk to prevent stomach upset.
• B. Increase fluid intake to 2-3 liters per day.
• C. Avoid taking the medication with dairy products.
• D. Continue taking the medication even if symptoms improve.

Correct answer: B

Rationale: Ciprofloxacin can cause crystalluria, so increasing fluid intake to 2-3 liters per day helps flush out the medication and prevent crystal formation in the kidneys. This also ensures adequate hydration, which supports the body's ability to fight the infection. Choice A is incorrect because ciprofloxacin should not be taken with dairy products as they can interfere with the absorption of the medication. Choice D is incorrect because although it's important to complete the full course of antibiotics, it's equally crucial to report any improvement in symptoms to the healthcare provider.

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