Nursing Elites

1. A nurse is caring for a client who is receiving total parenteral nutrition. Which of the following laboratory findings should the nurse report to the provider?

• A. Prealbumin level of 20 mg/dL
• B. Serum albumin level of 3.5 g/dL
• C. Serum sodium level of 138 mEq/L
• D. Blood glucose level of 120 mg/dL

Correct answer: D

Rationale: The correct answer is D because a blood glucose level of 120 mg/dL falls within the normal range. A low serum albumin level, as mentioned in choice B, should be reported as it may indicate malnutrition. Choices A and C are within normal ranges and would not typically require immediate reporting.

2. A client is receiving continuous IV nitroprusside for severe hypertension. Which action should the nurse take?

• A. Keep calcium gluconate at the bedside.
• B. Monitor blood pressure every 2 hours.
• C. Limit IV exposure to light.
• D. Attach an inline filter to the IV tubing.

Correct answer: C

Rationale: The correct action for the nurse to take is to limit IV exposure to light. Nitroprusside is light-sensitive, and exposure to light can lead to its degradation, potentially reducing its efficacy in treating severe hypertension. Keeping calcium gluconate at the bedside (Choice A) is not directly related to managing nitroprusside infusion. While monitoring blood pressure every 2 hours (Choice B) is important in managing hypertension, it is not the immediate action required to ensure medication efficacy. Attaching an inline filter to the IV tubing (Choice D) may help filter particles but does not address the critical concern of light sensitivity associated with nitroprusside administration.

3. A nurse is reviewing the medical history of a client who has angina. Which of the following findings in the client's medical history should the nurse identify as a risk factor for angina?

• A. Hyperlipidemia.
• B. COPD.
• C. Seizure disorder.
• D. Hyponatremia.

Correct answer: A

Rationale: The correct answer is A: Hyperlipidemia. Hyperlipidemia, which is an elevated level of lipids (fats) in the blood, is a well-established risk factor for angina. High levels of lipids can lead to atherosclerosis, a condition where fatty deposits build up in the arteries, reducing blood flow to the heart muscle and increasing the risk of angina. Choice B, COPD (Chronic Obstructive Pulmonary Disease), is not directly linked to an increased risk of angina. COPD primarily affects the lungs and is not a known risk factor for angina. Choice C, Seizure disorder, and Choice D, Hyponatremia (low sodium levels), are also not typically associated with an increased risk of angina. While medical conditions like hypertension, diabetes, and smoking are other common risk factors for angina, hyperlipidemia is specifically known for its impact on blood vessels, making it a key risk factor to identify in a client's medical history.

4. A nurse is preparing discharge information for a client who has type 2 diabetes mellitus. Which of the following resources should the nurse provide to the client?

• A. Personal blogs about managing the adverse effects of diabetes medications.
• B. Food label recommendations from the Institute of Medicine.
• C. Diabetes medication information from the Physicians' Desk Reference.
• D. Food exchange lists for meal planning from the American Diabetes Association.

Correct answer: D

Rationale: The correct answer is D. Food exchange lists from the American Diabetes Association are valuable resources for individuals with diabetes as they provide specific guidance on meal planning and portion control, which are crucial for managing blood sugar levels. Choice A is incorrect because personal blogs may not always provide accurate or evidence-based information. Choice B is incorrect as food label recommendations, while important, may not offer the structured guidance needed for meal planning in diabetes. Choice C is also incorrect as medication information is different from dietary guidance needed for diabetes management.

5. What is the best method to assess for fluid overload in patients with heart failure?

• A. Monitor daily weight
• B. Check for jugular vein distention
• C. Check for pitting edema
• D. Check for fluid retention

Correct answer: A

Rationale: The correct answer is A: Monitor daily weight. Daily weight monitoring is the most accurate method to assess fluid overload in patients with heart failure. Changes in weight can indicate fluid retention before visible signs like jugular vein distention or pitting edema appear. Checking for jugular vein distention (choice B) is helpful but may not be as sensitive as daily weight monitoring. Pitting edema (choice C) and fluid retention (choice D) are signs of fluid overload, but daily weight monitoring is a more proactive approach to detect changes early.

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