Nursing Elites

1. A healthcare professional is reviewing the results of renal function testing in a client with renal calculi. Which finding indicates to the healthcare professional that the client’s blood urea nitrogen (BUN) level is within the normal range?

• A. 2 mg/dL
• B. 18 mg/dL
• C. 25 mg/dL
• D. 35 mg/dL

Correct answer: B

Rationale: The normal BUN ranges from 5 to 20 mg/dL. A BUN level of 18 mg/dL falls within this normal range. Values of 25 and 35 mg/dL are elevated, suggesting potential renal insufficiency. Choice A (2 mg/dL) is abnormally low and not indicative of a normal BUN level.

2. A client receives a prescription for 1 liter of lactated Ringer's intravenously to be infused over 6 hours. How many mL/hr should the nurse program the infusion pump to deliver? (Enter numerical value only. If rounding is needed, round to the nearest whole number.)

• A. 167 mL/hr
• B. 200 mL/hr
• C. 83 mL/hr
• D. 111 mL/hr

Correct answer: A

Rationale: The correct infusion rate is 167 mL/hr. This is calculated by dividing the total volume (1000 mL) by the total time (6 hours), resulting in 166.67 mL/hr, which should be rounded to the nearest whole number as 167 mL/hr. This calculation ensures a steady infusion rate over the specified time frame. Choices B, C, and D are incorrect as they do not accurately reflect the correct calculation based on the volume and time provided in the prescription.

3. In a client with congestive heart failure, the nurse would be correct in withholding a dose of digoxin without specific instruction from the healthcare provider if the client's

• A. serum digoxin level is 1.5 ng/mL.
• B. blood pressure is 104/68 mmHg.
• C. serum potassium level is 3 mEq/L.
• D. apical pulse is 68/min.

Correct answer: C

Rationale: The correct answer is C. Hypokalemia can precipitate digitalis toxicity in individuals on digoxin, increasing the risk of dangerous dysrhythmias. A serum potassium level of 3 mEq/L is below the normal range (3.5 to 5.5 mEq/L) and indicates hypokalemia, which can potentiate the effects of digoxin. Choices A, B, and D are not directly related to the potential for digitalis toxicity. Serum digoxin level of 1.5 ng/mL is within the therapeutic range, blood pressure of 104/68 mmHg is not a contraindication for administering digoxin, and an apical pulse of 68/min is within the normal range and not a reason to withhold digoxin.

4. An older client with long-term type 2 diabetes Mellitus (DM) is seen in the clinic for a routine health assessment. Which assessment would the nurse complete to determine if a patient with type 2 diabetes Mellitus (DM) is experiencing long-term complications?

• A. Signs of respiratory tract infection
• B. Sensation in feet and legs
• C. Skin condition of lower extremities
• D. Serum creatinine and blood urea nitrogen (BUN)

Correct answer: B

Rationale: Assessing sensation in the feet and legs is crucial for detecting diabetic neuropathy, a common long-term complication of diabetes. While signs of respiratory tract infection, skin condition of lower extremities, and serum creatinine and blood urea nitrogen levels are important assessments in diabetic care, they are not specific for detecting long-term complications like neuropathy.

5. Which of the following is the best indicator of fluid balance in a patient with heart failure?

• A. Daily weight measurements.
• B. Monitoring intake and output.
• C. Assessing skin turgor.
• D. Checking for peripheral edema.

Correct answer: A

Rationale: Daily weight measurements are the best indicator of fluid balance in a patient with heart failure. Changes in weight reflect fluid retention or loss more accurately than other methods. Monitoring intake and output (choice B) is essential but may not provide a comprehensive picture of fluid status. Skin turgor (choice C) and checking for peripheral edema (choice D) are more indicative of dehydration and fluid overload, respectively, rather than overall fluid balance.

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