Nursing Elites

1. In evaluating a 10-year-old child with meningitis suspected of having diabetes insipidus, which finding is indicative of diabetes insipidus?

• A. Decreased urine specific gravity.
• B. Elevated urine glucose.
• C. Decreased serum potassium.
• D. Increased serum sodium.

Correct answer: A

Rationale: Diabetes insipidus is characterized by the kidneys' inability to concentrate urine, leading to decreased urine specific gravity. This results in the excretion of large volumes of dilute urine, causing a decrease in urine specific gravity. Therefore, when evaluating a suspected case of diabetes insipidus, a finding of decreased urine specific gravity is indicative of this condition.

2. A client with myelogenous leukemia is receiving an autologous bone marrow transplantation (BMT). What is the priority intervention that the nurse should implement when the bone marrow is repopulating?

• A. Administer sargramostim (Leukine, Prokine).
• B. Infuse PRBC and platelet transfusions.
• C. Give parenteral prophylactic antibiotics.
• D. Maintain a protective isolation environment.

Correct answer: D

Rationale: Maintaining a protective isolation environment is crucial during the repopulation of bone marrow post-transplant to reduce the risk of infections. The client's immune system is compromised during this period, making them highly susceptible to infections. By implementing protective isolation measures, the nurse can help prevent exposure to pathogens, safeguarding the client's health and supporting the success of the transplantation.

3. A client diagnosed with dementia is disoriented, wandering, has a decreased appetite, and is having trouble sleeping. What is the priority nursing problem for this client?

• A. Disturbed thought processes.
• B. Altered sleep pattern.
• C. Imbalanced nutrition: less than.
• D. Risk for injury.

Correct answer: D

Rationale: The correct answer is 'Risk for injury.' In a client with dementia who is disoriented, wandering, and experiencing sleep disturbances, the priority nursing problem is the risk for injury. Disorientation and wandering behavior can lead to accidents, falls, or other harmful situations, making it crucial for the nurse to address the safety concerns first to prevent any potential harm to the client.

4. A client with hepatic encephalopathy is being treated with lactulose. What is an expected outcome of this treatment?

• A. Reduction in blood ammonia levels
• B. Improvement in liver enzyme levels
• C. Decrease in bilirubin levels
• D. Increase in urine output

Correct answer: A

Rationale: Lactulose is used to treat hepatic encephalopathy by reducing blood ammonia levels through promoting its excretion via the intestines. Elevated ammonia levels contribute to the development of encephalopathy symptoms, so by lowering them, the client's neurological status can improve.

5. The nurse has completed the admission assessment of a client and has determined that the client's body mass index (BMI) is 33.5 kg/m2. What health promotion advice should the nurse provide to the client?

• A. It would be very helpful if you could integrate more physical activity into your routine.
• B. You're considered to be overweight, so you should be diligent about maintaining a healthy diet.
• C. You might want to consider some of the surgical options that have been developed for treating obesity.
• D. With your permission, I'd like you to refer to a support group for individuals who live with severe obesity.

Correct answer: A

Rationale: Increasing physical activity is a key component of managing BMI and overall health.

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