Nursing Elites

1. A 30-year-old woman is admitted to the hospital with complaints of severe abdominal cramping and diarrhea. The nurse evaluates the effectiveness of the patient's intravenous therapy. Which of the following laboratory tests BEST reflects hydration status?

• A. Erythrocyte sedimentation rate.
• B. White blood cell count.
• C. Hematocrit.
• D. Serum glucose.

Correct answer: C

Rationale: Hematocrit is the best indicator of hydration status because it reflects the proportion of red blood cells in the blood. An increased hematocrit indicates dehydration, as the blood becomes more concentrated due to fluid loss. Erythrocyte sedimentation rate (Choice A) is a nonspecific marker of inflammation, not hydration status. White blood cell count (Choice B) is an indicator of infection or inflammation. Serum glucose (Choice D) is used to monitor blood sugar levels, not hydration status.

2. Which of the following laboratory results would be expected in a client with peritonitis?

• A. Partial thromboplastin time above 100 seconds
• B. Hemoglobin level below 10 mg/dL
• C. Potassium level above 5.5 mEq/L
• D. White blood cell count above 15,000

Correct answer: D

Rationale: A white blood cell count above 15,000 is indicative of an infection, such as peritonitis.

3. The client with chronic pancreatitis needs information on dietary modification to manage the health problem. The nurse teaches the client to limit which of the following items in the diet?

• A. Carbohydrate
• B. Protein
• C. Fat
• D. Water-soluble vitamins

Correct answer: C

Rationale: The client should limit fat in the diet. The client also should take in small meals, which also will reduce the amount of carbohydrates and protein that the client must digest at any one time. The client does not need to limit water-soluble vitamins in the diet.

4. Which of the following interventions should be included in the medical management of Crohn’s disease?

• A. Increasing oral intake of fiber
• B. Administering laxatives
• C. Using long-term steroid therapy
• D. Increasing physical activity

Correct answer: C

Rationale: Long-term steroid therapy is often used in the management of Crohn's disease to reduce inflammation and suppress the immune response.

5. A client with viral hepatitis states, 'I am so yellow.' The nurse most appropriately would

• A. Assist the client in expressing feelings.
• B. Do most of the activities of daily living for the client.
• C. Provide information to the client only when the client requests it.
• D. Restrict visitors until the jaundice subsides.

Correct answer: A

Rationale: To assist the client in adapting to changes in appearance, the nurse must encourage participation in self-care to foster independence and self-esteem. The nurse should encourage the client to ask questions to clarify misconceptions, learn ways to prevent the spread of hepatitis to reduce fear, and make appropriate decisions. Restricting visitors will reinforce the client’s negative self-esteem.

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