Nursing Elites

1. A nurse contacts the healthcare provider after reviewing a client’s laboratory results and noting a blood urea nitrogen (BUN) of 35 mg/dL and a creatinine of 1.0 mg/dL. For which action should the nurse recommend a prescription?

• A. Intravenous fluids
• B. Hemodialysis
• C. Fluid restriction
• D. Urine culture and sensitivity

Correct answer: A

Rationale: The normal range for BUN is 10 to 20 mg/dL, and for creatinine, it is 0.6 to 1.2 mg/dL in males and 0.5 to 1.1 mg/dL in females. Creatinine is a more specific marker for kidney function compared to BUN. In this case, the client's creatinine level is within the normal range, indicating a non-renal cause for the elevated BUN. Dehydration is a common cause of increased BUN, so the appropriate action would be to recommend intravenous fluids to address the dehydration. Fluid restriction is not indicated as the client needs hydration. Hemodialysis is not appropriate for dehydration and is typically reserved for renal failure. The laboratory results do not suggest an infection, making a urine culture and sensitivity unnecessary in this scenario.

2. A client recovering from surgery has a large abdominal wound. Which of the following foods, high in vitamin C, should the nurse encourage the client to eat to promote wound healing?

• A. Steak
• B. Veal
• C. Cheese
• D. Oranges

Correct answer: D

Rationale: Oranges are a rich source of vitamin C, which is essential for wound healing due to its role in collagen synthesis. Citrus fruits like oranges, as well as other fruits and vegetables such as strawberries, kiwi, bell peppers, and broccoli, are high in vitamin C. Meats like steak and veal are not significant sources of vitamin C; they are primarily sources of protein. Cheese is not a good source of vitamin C but does provide calcium and protein.

3. The healthcare provider is assessing a client undergoing peritoneal dialysis. Which of the following findings should be reported immediately to the physician?

• A. Clear dialysate outflow.
• B. Clear dialysate inflow.
• C. Cloudy dialysate outflow.
• D. Increased blood pressure.

Correct answer: C

Rationale: Cloudy dialysate outflow should be reported immediately to the physician as it is a concerning sign of peritonitis, a severe infection of the peritoneum. Peritonitis is a serious complication of peritoneal dialysis that requires prompt medical intervention to prevent further complications. Clear dialysate outflow and inflow are normal findings in peritoneal dialysis and do not indicate an immediate need for intervention. Increased blood pressure, while important to monitor, is not directly related to peritoneal dialysis and would not be the priority over the potentially life-threatening complication of peritonitis.

4. The client is being educated by the healthcare provider about risk factors associated with atherosclerosis and methods to reduce the risk. Which of the following is a risk factor that the client cannot modify?

• A. Diabetes
• B. Age
• C. Exercise level
• D. Dietary preferences

Correct answer: B

Rationale: Age is a nonmodifiable risk factor for atherosclerosis because it is a natural part of the aging process. While lifestyle factors such as diabetes, exercise level, and dietary preferences can be modified to reduce the risk of atherosclerosis, age cannot be altered. Therefore, age is the correct answer. Diabetes, exercise level, and dietary preferences can all be improved or managed through interventions and lifestyle changes to mitigate the risk of atherosclerosis.

5. Which electrolyte imbalance is most likely to be seen in a patient with chronic kidney disease?

• A. Hypernatremia.
• B. Hyperkalemia.
• C. Hypocalcemia.
• D. Hypokalemia.

Correct answer: B

Rationale: In chronic kidney disease, hyperkalemia is the most common electrolyte imbalance due to the kidneys' reduced ability to excrete potassium. This impaired kidney function leads to potassium retention in the body, resulting in elevated serum potassium levels. Hypernatremia (increased sodium levels) is less likely in chronic kidney disease as the kidneys typically still function to regulate sodium levels. Hypocalcemia (low calcium levels) is not a prominent electrolyte imbalance in chronic kidney disease unless there are additional factors involved. Hypokalemia (low potassium levels) is less common in chronic kidney disease, as the primary issue is usually potassium retention rather than deficiency.

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