Nursing Elites

1. A healthcare professional is assessing a client who has chronic kidney disease. Which of the following findings should the healthcare professional report to the provider?

• A. Urine output of 80 mL/hr
• B. Blood pressure of 140/90 mm Hg
• C. Serum creatinine 2.8 mg/dL
• D. Heart rate of 72/min

Correct answer: C

Rationale: The correct answer is C. A serum creatinine level of 2.8 mg/dL indicates impaired kidney function and should be reported to the healthcare provider. Elevated serum creatinine levels are indicative of decreased kidney function and potential progression of chronic kidney disease. Choices A, B, and D are within normal ranges and do not signify immediate concerns related to kidney disease. Urine output of 80 mL/hr is appropriate, a blood pressure of 140/90 mm Hg is considered prehypertensive but not acutely concerning, and a heart rate of 72/min falls within the normal range.

2. A nurse is providing dietary teaching to a client who has a new diagnosis of irritable bowel syndrome. Which of the following recommendations should the nurse include?

• A. Consume food high in bran fiber.
• B. Increase intake of milk products.
• C. Sweeten foods with fructose corn syrup.
• D. Increase foods high in gluten.

Correct answer: A

Rationale: The correct recommendation for a client with irritable bowel syndrome is to consume food high in bran fiber. Bran fiber promotes regularity and can help reduce symptoms of IBS. Choices B, C, and D are incorrect because increasing milk products, sweetening foods with fructose corn syrup, and consuming foods high in gluten can exacerbate symptoms of irritable bowel syndrome in some individuals.

3. A client has a new prescription for furosemide. Which of the following laboratory values should the nurse monitor?

• A. Potassium
• B. Sodium
• C. Calcium
• D. Hemoglobin

Correct answer: A

Rationale: When a client is prescribed furosemide, monitoring potassium levels is crucial due to the drug's potential to cause hypokalemia. Furosemide is a loop diuretic that promotes potassium excretion in the urine, leading to a risk of low potassium levels. Monitoring potassium levels helps in detecting and preventing hypokalemia, which can result in adverse effects like cardiac dysrhythmias. Sodium, calcium, and hemoglobin levels are usually not directly affected by furosemide, making them less pertinent for monitoring in this specific scenario.

4. A client is prescribed furosemide and needs to consume potassium-rich foods. Which of the following foods should the client be advised to include in the diet?

• A. Grapes.
• B. Apples.
• C. Bananas.
• D. Rice.

Correct answer: C

Rationale: The correct answer is C: Bananas. Bananas are rich in potassium and should be included in the diet of clients taking furosemide, a potassium-wasting diuretic. Grapes, apples, and rice are not as high in potassium as bananas and would not be as effective in replenishing potassium levels in clients taking furosemide.

5. What is the best way to assess for fluid overload in a patient with heart failure?

• A. Check daily weight
• B. Check blood pressure
• C. Monitor heart sounds
• D. Assess for jugular vein distention

Correct answer: A

Rationale: The correct answer is to 'Check daily weight.' Monitoring daily weight is the most accurate method to assess for fluid overload in patients with heart failure. Weight gain can indicate fluid retention, a common issue in heart failure patients. Checking blood pressure (Choice B) can provide information about hemodynamic status but may not be as specific for fluid overload as monitoring weight. Monitoring heart sounds (Choice C) can provide information about cardiac function but may not directly assess fluid overload. Assessing for jugular vein distention (Choice D) can be a sign of increased central venous pressure but may not always correlate with fluid overload as accurately as daily weight checks.

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