Nursing Elites

1. A nurse is reviewing the laboratory results for a client with a history of atherosclerosis and notes elevated cholesterol levels. Which statement by the client indicates the nurse should plan follow-up instruction on a low-cholesterol diet?

• A. ''I take an omega-3 supplement daily.''
• B. ''I cook my food with canola oil.''
• C. ''I eat three eggs for breakfast each morning.''
• D. ''I flavor my meat with lemon juice.''

Correct answer: C

Rationale: The correct answer is C. Eating three eggs daily increases cholesterol intake, which could exacerbate atherosclerosis. Choice A is incorrect because taking an omega-3 supplement can actually help reduce cholesterol levels. Choice B is incorrect as canola oil is a healthier choice compared to saturated fats. Choice D is incorrect since flavoring meat with lemon juice does not significantly impact cholesterol levels.

2. The nurse had developed a close relationship with the family of a client who is dying. Which nursing intervention(s) are most appropriate in dealing with the family?

• A. Encouraging family discussion of feelings
• B. Accepting the family’s experience of anger
• C. Facilitating the use of spiritual practices identified by the family
• D. All of the above

Correct answer: D

Rationale: When a nurse has developed a close relationship with a dying client's family, it is crucial to provide comprehensive support. Encouraging family discussion of feelings helps them express their emotions and concerns, fostering a sense of relief. Accepting the family's experience of anger without judgment validates their emotions and promotes trust. Facilitating the use of spiritual practices identified by the family acknowledges their beliefs and values, offering comfort and solace. Therefore, all of the above interventions are essential in providing holistic care and support during such a challenging time. Choices A, B, and C each play a vital role in addressing different aspects of the family's emotional and spiritual needs, making option D the correct answer.

3. The nurse is caring for clients on a cardiac floor. Which client should the nurse assess first?

• A. The client with three (3) unifocal PVCs in a minute
• B. The client diagnosed with coronary artery disease who wants to ambulate
• C. The client diagnosed with mitral valve prolapse with an audible S3
• D. The client diagnosed with pericarditis who is in normal sinus rhythm

Correct answer: C

Rationale: The correct answer is C because an audible S3 in a client with mitral valve prolapse could indicate heart failure and requires immediate assessment. Choice A is not as urgent as an audible S3 in mitral valve prolapse. Choice B, a client with coronary artery disease wanting to ambulate, does not present an immediate concern compared to a potential heart failure indicated by an audible S3. Choice D, a client with pericarditis in normal sinus rhythm, is stable and does not require immediate attention when compared to a potential heart failure situation signified by an audible S3 in mitral valve prolapse.

4. The nurse is caring for a client on strict bed rest. Which intervention is the priority when caring for this client?

• A. Encourage the client to drink liquids
• B. Perform active range of motion exercises
• C. Elevate the head of the bed to 45 degrees
• D. Provide a high-fiber diet to the client

Correct answer: B

Rationale: The correct answer is to perform active range of motion exercises. When a client is on strict bed rest, performing range of motion exercises is a priority to prevent complications such as thromboembolism and muscle atrophy. Option A may be important but not the priority compared to maintaining mobility. Option C is incorrect because elevating the head of the bed to 45 degrees is not necessary for a client on strict bed rest. Option D, providing a high-fiber diet, is also not the priority intervention compared to ensuring range of motion exercises are performed.

5. Which laboratory data indicate the client’s pancreatitis is improving?

• A. The amylase and lipase serum levels are decreased
• B. The white blood cell count (WBC) is decreased
• C. The conjugated and unconjugated bilirubin levels are decreased
• D. The blood urea nitrogen (BUN) serum level is decreased

Correct answer: A

Rationale: The correct answer is A. Amylase and lipase are specific markers for pancreatitis. A decrease in their serum levels indicates improvement in pancreatitis. Choice B, a decreased white blood cell count (WBC), is more indicative of an improvement in infection rather than pancreatitis. Choices C and D, decreased bilirubin levels and blood urea nitrogen (BUN) levels respectively, are not specific markers for pancreatitis improvement.

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