Nursing Elites

1. A nurse is caring for a client who is well-hydrated and who demonstrates no evidence of anemia. Which of the following laboratory values gives the nurse an assessment of the adequacy of the client's protein uptake and synthesis?

• A. Albumin
• B. Calcium
• C. Sodium
• D. Potassium

Correct answer: A

Rationale: The correct answer is Albumin. Albumin is a protein made by the liver and is a key indicator of the body's protein status. Low levels of albumin can indicate inadequate protein intake or synthesis. Choices B, C, and D (Calcium, Sodium, and Potassium) are not direct indicators of protein uptake and synthesis. Calcium is related to bone health, Sodium to fluid balance, and Potassium to nerve and muscle function.

2. The nurse understands that malnutrition is a prevalent issue among hospitalized individuals. What is it commonly associated with?

• A. Decreased health care expenses
• B. Elevated blood pressure
• C. Decreased mortality rates
• D. A compromised immune system

Correct answer: D

Rationale: Malnutrition is often associated with a weakened immune system. This is because when the body is not sufficiently nourished, it lacks the necessary nutrients to maintain a well-functioning immune system, making patients more vulnerable to infections and other health complications. This can potentially increase mortality rates and prolong hospital stays, contrary to choice C. Choices A and B are incorrect as malnutrition does not lead to decreased health care costs or high blood pressure. In fact, it may increase health care costs due to the potential for increased complications and extended hospital stays.

3. Which of the following actions would be of highest priority with regards to the external shunt?

• A. Avoid taking blood pressure or blood sample from the arm with the shunt
• B. Instruct the patient not to exercise the arm with the shunt
• C. Heparinize the shunt daily
• D. Change the dressing of the shunt daily

Correct answer: C

Rationale: Heparinizing the shunt daily (choice C) is the highest priority action as it prevents the formation of blood clots that can occlude the shunt, leading to potential complications such as thrombosis. Avoiding taking blood pressure or blood samples from the arm with the shunt (choice A) is also important, but secondary to heparinizing the shunt. Similarly, instructing the patient not to exercise the arm with the shunt (choice B) can help prevent unnecessary strain on the shunt, but it is not as critical as preventing clot formation. Changing the dressing of the shunt daily (choice D) is a standard nursing care practice to prevent infection, but again, it is not as critical as ensuring the shunt remains patent through daily heparinization.

4. What principle is used when the client with fever loses heat through giving cooling bed bath to lower body temperature?

• A. Radiation C. Evaporation
• B. Convection D. Conduction
• C.
• D.

Correct answer: D

Rationale: Understanding the underlying pathology and therapeutic techniques ensures that nursing care is not only reactive but also preventative, reducing the risk of complications.

5. Can fluid retention cause lab values to be deceptively high, whereas dehydration may cause the values to be deceptively low?

• A. TRUE
• B. FALSE
• C. Not always
• D. Sometimes

Correct answer: B

Rationale: The statement is incorrect. Fluid retention generally results in lab values appearing deceptively low, not high, because the excess fluid dilutes the concentration of substances in the blood. Conversely, dehydration can make lab values appear deceptively high as the reduced fluid volume in the body means substances in the blood are less diluted. Choices 'C: Not always' and 'D: Sometimes' are not specific and do not directly address the statement in the question, hence they are incorrect.

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