Nursing Elites

1. A nurse is caring for a client who has cancer and is receiving total parenteral nutrition (TPN). Which of the following lab values indicates the treatment is effective?

• A. Hct 43%
• B. WBC 8,000/uL
• C. Albumin 4.2 g/dL
• D. Calcium 9.4 mg/dL

Correct answer: C

Rationale: The correct answer is Albumin 4.2 g/dL. Albumin is a protein produced by the liver and is a key indicator of nutritional status. In a client receiving total parenteral nutrition (TPN), an increase in albumin level indicates that the treatment is effective in providing adequate nutrition support. Hct (hematocrit), WBC (white blood cell count), and calcium levels are not direct indicators of the effectiveness of TPN in this context.

2. 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.

3. A nurse is assessing a client who reports muscle spasms in his calves and tingling in his hands. The client indicates consuming a low intake of milk products and green leafy vegetables. The nurse should identify that the client's findings indicate a deficiency in which of the following sources of nutrition?

• A. Iron
• B. Omega-3 fatty acids
• C. Vitamin C
• D. Calcium

Correct answer: D

Rationale: The correct answer is D, Calcium. Muscle spasms and tingling suggest a calcium deficiency, which is commonly associated with a low intake of milk products and green leafy vegetables. Iron (choice A) deficiency typically presents with fatigue and weakness, not muscle spasms and tingling. Omega-3 fatty acids (choice B) are essential for brain function and heart health, but their deficiency does not manifest as muscle spasms and tingling. Vitamin C (choice C) deficiency leads to scurvy with symptoms like bleeding gums and bruising, not muscle spasms and tingling.

4. A client with a large lower-leg ulcer needs protein for wound healing. Which of the following foods should the nurse suggest?

• A. Kidney beans
• B. Grilled salmon
• C. Peanut butter
• D. Raw spinach

Correct answer: B

Rationale: Grilled salmon is the best choice for providing high-quality protein for wound healing. Salmon is rich in essential amino acids, omega-3 fatty acids, and vitamin D, which can help promote tissue repair and reduce inflammation. Kidney beans, peanut butter, and raw spinach are good protein sources but do not offer the same level of high-quality protein and nutrients needed specifically for wound healing.

5. A client is being instructed by a nurse about foods that should be included in a low-fiber diet. Which statement by the client indicates understanding?

• A. I can cut up carrots and celery sticks for my lunch.
• B. I will eat a bran muffin for my mid-morning snack.
• C. I will have oatmeal with skim milk for my breakfast.
• D. I should choose canned peaches for my fruit serving.

Correct answer: D

Rationale: The correct answer is D because canned peaches are lower in fiber compared to the other options. Carrots, celery sticks, bran muffins, and oatmeal are high-fiber choices, which are not suitable for a low-fiber diet. Choosing canned peaches aligns with the requirements of a low-fiber diet.

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