Nursing Elites

1. A nurse is planning care for a client who has chronic kidney disease. Which finding indicates the need for hemodialysis?

• A. BUN 14 mg/dL
• B. Serum potassium 4.2 mEq/L
• C. Serum creatinine 5 mg/dL
• D. Serum calcium 9 mg/dL

Correct answer: C

Rationale: The correct answer is C. A serum creatinine level of 5 mg/dL is significantly elevated and indicates the need for hemodialysis to help filter waste products from the blood. Elevated creatinine levels suggest impaired kidney function and the inability to effectively filter waste from the body. Choices A, B, and D are within normal ranges and do not indicate the need for immediate hemodialysis in a client with chronic kidney disease.

2. A nurse is teaching a client with gestational diabetes about blood sugar control. Which of the following statements indicates understanding?

• A. I should test my blood sugar before each meal.
• B. I can eat any foods as long as I take my insulin.
• C. I should avoid all carbohydrates in my diet.
• D. I will only need to monitor my blood sugar at bedtime.

Correct answer: A

Rationale: The correct answer is A: 'I should test my blood sugar before each meal.' Monitoring blood sugar before meals is crucial for managing gestational diabetes as it helps in understanding how different foods affect blood sugar levels and adjusting insulin doses accordingly. Choice B is incorrect as food choices should be monitored carefully, not just relying on insulin. Choice C is incorrect because while it is important to manage carbohydrate intake, completely avoiding all carbohydrates is not recommended. Choice D is incorrect as blood sugar monitoring throughout the day is essential, not just at bedtime, to ensure proper control and management of gestational diabetes.

3. A client receiving chemotherapy is experiencing neutropenia. Which of the following should the nurse include in this client's education?

• A. Track oral temperature weekly
• B. Gardening is a good form of mild exercise
• C. Avoid crowded events
• D. Eat plenty of fresh fruits and vegetables

Correct answer: C

Rationale: Clients with neutropenia have a weakened immune system, making them susceptible to infections. Avoiding crowded events helps reduce the risk of exposure to pathogens, thereby minimizing the chance of infections. Tracking oral temperature is important for detecting fever early, which is a sign of infection and requires immediate medical attention. While gardening can be a good form of exercise, clients with neutropenia should avoid it due to the risk of exposure to bacteria and fungi present in soil. Eating fresh fruits and vegetables is generally encouraged for overall health but may carry a risk of bacterial contamination, which could be harmful to a client with neutropenia.

4. A healthcare provider is assessing a client who is receiving IV gentamicin three times daily. Which of the following findings indicates that the client is experiencing an adverse effect of this medication?

• A. Hypoglycemia
• B. Proteinuria
• C. Nasal congestion
• D. Visual disturbances

Correct answer: B

Rationale: Corrected Rationale: Gentamicin is known to cause nephrotoxicity as an adverse effect. Proteinuria, which is the presence of excess proteins in the urine, may indicate kidney damage from the medication. Monitoring renal function is crucial in clients receiving gentamicin. Choice A, hypoglycemia, is not a typical adverse effect of gentamicin. Choices C and D, nasal congestion and visual disturbances, are not commonly associated with gentamicin use or its adverse effects.

5. A nurse is teaching a client about fecal occult blood testing (FOBT) for the screening of colorectal cancer. Which of the following statements should the nurse include in the teaching?

• A. “Your provider will use stool samples from your bowel movement to perform the test.”
• B. “Your provider will prescribe a stimulant laxative prior to the procedure to cleanse the bowel.”
• C. “You should begin biennial fecal occult blood testing for colorectal cancer screening at 50 years old.”
• D. “You should avoid taking corticosteroids prior to testing.”

Correct answer: D

Rationale: The correct answer is D. The nurse should instruct the client to avoid corticosteroids and vitamin C prior to testing to prevent false-positive results. Choice A is incorrect because stool samples from bowel movements, not from digital rectal examinations, are used for FOBT. Choice B is incorrect because a stimulant laxative is not typically prescribed before FOBT; rather, the client is instructed to follow specific dietary restrictions. Choice C is incorrect because biennial fecal occult blood testing for colorectal cancer screening usually begins at 50 years old, not 40.

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