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. A nurse is caring for a client who has cancer and is receiving total parenteral nutrition (TPN). Which of the following lab values indicates the treatment is effective?

• A. Hct 43%
• B. WBC 8,000/uL
• C. Albumin 4.2 g/dL
• D. Calcium 9.4 mg/dL

Correct answer: C

Rationale: The correct answer is Albumin 4.2 g/dL. Albumin is a protein produced by the liver and is a key indicator of nutritional status. In a client receiving total parenteral nutrition (TPN), an increase in albumin level indicates that the treatment is effective in providing adequate nutrition support. Hct (hematocrit), WBC (white blood cell count), and calcium levels are not direct indicators of the effectiveness of TPN in this context.

3. To prevent baby bottle tooth decay, what should the nurse instruct?

• A. Water
• B. Milk
• C. Iron-fortified formula
• D. Unsweetened fruit juice

Correct answer: A

Rationale: The correct answer is A: Water. Water is the best choice to prevent baby bottle tooth decay as it does not cause tooth decay and is a good option for bedtime bottles. Milk (choice B) and iron-fortified formula (choice C) contain sugars that can contribute to tooth decay. Unsweetened fruit juice (choice D) also contains natural sugars that can be harmful to the baby's teeth.

4. What factor has been shown to contribute to poor nutritional health among adolescents?

• A. Most teens choose fruit juice and milk over soda
• B. Many teens consume energy drinks on a regular basis
• C. Teens have busy schedules and rarely drink fluids throughout the day
• D. Teens are more likely to consume low-fat milk

Correct answer: B

Rationale: The correct answer is B because many teens regularly consume energy drinks, which can contribute to poor nutritional health due to their high sugar and caffeine content, leading to unhealthy dietary patterns. Choice A is incorrect because choosing fruit juice and milk over soda would generally be considered a healthier choice. Choice C is incorrect as busy schedules leading to inadequate fluid intake might impact hydration but not necessarily poor nutritional health. Choice D is also incorrect as consuming low-fat milk is not typically a significant factor contributing to poor nutritional health among adolescents.

5. For an incontinent elderly client who frequently wets his bed and develops redness and skin excoriation at the perianal area, what is the best nursing goal?

• A. Ensure that the bed linen is always dry
• B. Frequently check the bed for wetness and keep it dry
• C. Place a rubber sheet under the client's buttocks
• D. Keep the patient clean and dry

Correct answer: A

Rationale: The best nursing goal for an incontinent elderly client with skin excoriation is to ensure that the bed linen is always dry. This helps in preventing further skin breakdown and promoting skin integrity. Choice B, to frequently check the bed for wetness and keep it dry, may not address the issue of prevention if the linen is not consistently dry. Choice C, placing a rubber sheet under the client's buttocks, focuses more on protecting the mattress rather than addressing the client's skin condition directly. Choice D, keeping the patient clean and dry, is important but does not specifically address the preventive aspect of maintaining dry bed linen.

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