Nursing Elites

1. A client's healthcare provider has ordered a 'liver panel' in response to the client's development of jaundice. When reviewing the results of this laboratory testing, the nurse should expect to review what blood tests? Select one that doesn't apply.

• A. Alanine aminotransferase (ALT)
• B. C-reactive protein (CRP)
• C. Gamma-glutamyl transferase (GGT)
• D. Aspartate aminotransferase (AST)

Correct answer: B

Rationale: A 'liver panel' is a group of blood tests used to evaluate liver function. The components typically include ALT, GGT, and AST. While C-reactive protein (CRP) is a marker of inflammation and not part of a standard liver panel, it may be ordered for other diagnostic purposes.

2. Following a CVA, the nurse assesses that a client developed dysphagia, hypoactive bowel sounds, and a firm, distended abdomen. Which prescription for the client should the nurse question?

• A. Continuous tube feeding at 65 ml/hr via gastrostomy.
• B. Total parenteral nutrition to be infused at 125 ml/hour.
• C. Nasogastric tube connected to low intermittent suction.
• D. Metoclopramide (Reglan) intermittent piggyback.

Correct answer: A

Rationale: In a client with dysphagia, hypoactive bowel sounds, and a firm, distended abdomen post-CVA, continuous tube feeding at 65 ml/hr via gastrostomy may exacerbate abdominal distension and hypoactive bowel sounds. This situation requires immediate assessment and reevaluation before continuing with the prescription.

3. The nurse is planning care for a 16-year-old with juvenile rheumatoid arthritis (JRA). The nurse includes activities to strengthen and mobilize the joints and surrounding muscles. Which physical therapy regimen should the nurse encourage the adolescent to implement?

• A. Exercise in a swimming pool.
• B. Splint affected joints during activity.
• C. Perform passive range of motion exercises twice daily.
• D. Begin a training program of lifting weights and running.

Correct answer: A

Rationale: Exercising in a swimming pool is beneficial for adolescents with juvenile rheumatoid arthritis as it reduces stress on the joints while allowing movement and strengthening. The buoyancy of water supports the body, making exercises easier and less painful, while also providing resistance to strengthen muscles. This form of exercise can help improve joint mobility and overall function without causing excessive strain on the joints. Choices B, C, and D are incorrect because splinting affected joints, performing passive range of motion exercises, or beginning a training program of lifting weights and running can potentially exacerbate symptoms and cause additional stress on the joints, which is not recommended for individuals with juvenile rheumatoid arthritis.

4. A client is being educated about type 2 diabetes. The educator can confirm that the client understands the primary treatment for type 2 diabetes when the client states what?

• A. I read that a pancreas transplant will provide a cure for my diabetes.
• B. I will take my oral antidiabetic agents when my morning blood sugar is high.
• C. I will make sure to follow the weight loss plan designed by the dietitian.
• D. I will make sure I call the diabetes educator when I have questions about my insulin.

Correct answer: C

Rationale: The primary treatment approach for managing type 2 diabetes includes following a weight loss plan. Weight loss can improve insulin sensitivity and glycemic control in individuals with type 2 diabetes. Making dietary changes and maintaining a healthy weight are crucial components of managing this condition.

5. What dietary advice should the nurse provide to help reduce the occurrence of hot flashes in a post-menopausal client?

• A. Increase intake of spicy foods.
• B. Limit caffeine and alcohol consumption.
• C. Consume a high-protein diet.
• D. Eat more dairy products.

Correct answer: B

Rationale: Limiting caffeine and alcohol consumption is recommended to help reduce the frequency of hot flashes in post-menopausal individuals. Caffeine and alcohol can trigger hot flashes and worsen their occurrence. Encouraging the client to reduce these stimulants in their diet may help alleviate hot flashes and improve their quality of life.

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