Nursing Elites

1. In acute pancreatitis, a client experiencing severe abdominal pain should have which enzyme level closely monitored?

• A. Serum amylase.
• B. Serum sodium.
• C. Serum calcium.
• D. Serum potassium.

Correct answer: A

Rationale: In acute pancreatitis, serum amylase levels should be closely monitored. Elevated serum amylase levels are a key diagnostic marker for acute pancreatitis, aiding in the assessment and management of the patient's condition. Monitoring serum sodium, calcium, or potassium levels is not typically associated with acute pancreatitis and would not provide relevant information for this specific condition.

2. A client with newly diagnosed type 2 diabetes is preparing for discharge. Which statement by the client indicates a need for further teaching?

• A. I will take my insulin shots only when my blood sugar is high
• B. I need to follow a balanced diet and exercise regularly
• C. I should monitor my blood sugar levels regularly
• D. I need to take my medication as prescribed by my doctor

Correct answer: A

Rationale: In type 2 diabetes, insulin therapy is typically not the first-line treatment. Patients should follow their prescribed treatment plan, which may or may not include insulin. Taking insulin shots only when blood sugar is high can lead to uncontrolled glucose levels and complications. It is important to adhere to the prescribed medication regimen to manage diabetes effectively.

3. A male client in the day room becomes increasingly angry and aggressive when denied a day-pass. Which action should the nurse implement?

• A. Tell him he can have a day pass if he calms down.
• B. Put the client's behavior on extinction.
• C. Decrease the volume on the television set.
• D. Instruct the client to sit down and be quiet.

Correct answer: D

Rationale: Instructing the client to sit down and be quiet is a direct and assertive approach that can help de-escalate the situation safely. It sets clear boundaries and expectations for the client's behavior, which may help reduce agitation and aggression in this scenario. Offering a day pass if the client calms down (Choice A) might reinforce the aggressive behavior. Putting the client's behavior on extinction (Choice B) involves not reinforcing the behavior, but it may not directly address the immediate safety concern. Decreasing the volume on the television set (Choice C) does not address the client's behavior directly and may not effectively manage the escalating situation.

4. In a client with liver cirrhosis experiencing confusion and disorientation, what condition is most likely causing these symptoms?

• A. Hepatic encephalopathy
• B. Hypoglycemia
• C. Electrolyte imbalance
• D. Dehydration

Correct answer: A

Rationale: Hepatic encephalopathy is the most likely condition causing confusion and disorientation in a client with liver cirrhosis. This condition is a common complication of liver cirrhosis and is characterized by cognitive impairment due to elevated ammonia levels in the blood. The build-up of ammonia affects brain function, leading to symptoms such as confusion, disorientation, and altered consciousness. Hypoglycemia (choice B) may present with confusion but is less likely in a client with liver cirrhosis without a history of diabetes or insulin use. Electrolyte imbalance (choice C) and dehydration (choice D) can contribute to confusion but are not the primary causes in a client with liver cirrhosis experiencing these symptoms.

5. A client with a history of asthma is prescribed salmeterol (Serevent). Which instruction should the nurse provide?

• A. Use this medication for acute asthma attacks.
• B. Use this medication before using your albuterol inhaler.
• C. Use this medication twice daily for long-term control.
• D. Use this medication as needed for wheezing.

Correct answer: C

Rationale: The correct instruction for a client prescribed salmeterol (Serevent) is to use it twice daily for long-term control. Salmeterol is a long-acting bronchodilator that is not intended for acute asthma attacks or as-needed use for wheezing. Choice A is incorrect because salmeterol is not used for acute asthma attacks. Choice B is incorrect as salmeterol is not meant to replace the albuterol inhaler but rather used for long-term control. Choice D is incorrect because salmeterol should not be used as needed; it is a maintenance medication for asthma.

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