Nursing Elites

1. A client with kidney stones from secondary hyperoxaluria requires medication. Which medication should the nurse anticipate administering?

• A. Phenazopyridine (Pyridium)
• B. Propantheline (Pro-Banthine)
• C. Tolterodine (Detrol LA)
• D. Allopurinol (Zyloprim)

Correct answer: D

Rationale: The correct answer is D: Allopurinol (Zyloprim). Allopurinol is used to treat kidney stones caused by secondary hyperoxaluria. This medication helps prevent the formation of certain types of kidney stones. Choices A, B, and C are incorrect. Phenazopyridine (Pyridium) is given to clients with urinary tract infections, not for kidney stones. Propantheline (Pro-Banthine) is an anticholinergic medication used for treating certain gastrointestinal conditions, not kidney stones. Tolterodine (Detrol LA) is also an anticholinergic with smooth muscle relaxant properties, primarily used to treat overactive bladder conditions, not kidney stones.

2. The nurse assesses a client with advanced cirrhosis of the liver for signs of hepatic encephalopathy. Which finding would the nurse consider an indication of progressive hepatic encephalopathy?

• A. An increase in abdominal girth.
• B. Hypertension and a bounding pulse.
• C. Decreased bowel sounds.
• D. Difficulty in handwriting.

Correct answer: D

Rationale: Difficulty in handwriting is a common early sign of hepatic encephalopathy. Changes in handwriting can indicate progression or reversal of hepatic encephalopathy leading to coma. Choice (A) is a sign of ascites, not hepatic encephalopathy. Hypertension and a bounding pulse (Choice B) are not typically associated with hepatic encephalopathy. Decreased bowel sounds (Choice C) do not directly indicate an increase in serum ammonia level, which is the primary cause of hepatic encephalopathy.

3. A healthcare professional is reviewing the results of renal function testing in a client with renal calculi. Which finding indicates to the healthcare professional that the client’s blood urea nitrogen (BUN) level is within the normal range?

• A. 2 mg/dL
• B. 18 mg/dL
• C. 25 mg/dL
• D. 35 mg/dL

Correct answer: B

Rationale: The normal BUN ranges from 5 to 20 mg/dL. A BUN level of 18 mg/dL falls within this normal range. Values of 25 and 35 mg/dL are elevated, suggesting potential renal insufficiency. Choice A (2 mg/dL) is abnormally low and not indicative of a normal BUN level.

4. A client with nephrotic syndrome is being assessed by a nurse. For which clinical manifestations should the nurse assess? (Select all that apply.)

• A. Proteinuria
• B. Hypoalbuminemia
• C. Lipiduria
• D. All of the above

Correct answer: D

Rationale: Nephrotic syndrome is characterized by glomerular damage, leading to proteinuria (excessive protein in the urine), hypoalbuminemia (low levels of albumin in the blood), and lipiduria (lipids in the urine). These manifestations are key indicators of nephrotic syndrome. Edema, often severe, is also common due to decreased plasma oncotic pressure from hypoalbuminemia. The correct answer is 'All of the above' because all three manifestations are associated with nephrotic syndrome. Dehydration is not a typical finding in nephrotic syndrome as it is more commonly associated with fluid retention and edema. Dysuria is a symptom of cystitis, not nephrotic syndrome. CVA tenderness is more indicative of inflammatory changes in the kidney rather than nephrotic syndrome.

5. Which of the following is a priority intervention for a patient with heart failure?

• A. Administering diuretics.
• B. Administering oxygen.
• C. Administering beta-blockers.
• D. Administering vasodilators.

Correct answer: B

Rationale: Administering oxygen is a priority intervention in heart failure because it helps improve oxygenation, alleviate hypoxemia, and reduce the workload on the heart. Oxygen therapy is crucial in managing acute heart failure exacerbations. While diuretics (Choice A) are commonly used in heart failure to reduce fluid overload, administering oxygen takes precedence due to its immediate impact on oxygen delivery. Beta-blockers (Choice C) and vasodilators (Choice D) are also important in heart failure management, but in the acute setting, ensuring adequate oxygen supply is the priority.

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