Nursing Elites

1. A client with cirrhosis and ascites is being cared for by a nurse. Which of the following interventions should the nurse include in the plan of care?

• A. Decrease the client's fluid intake.
• B. Increase the client's saturated fat intake.
• C. Increase the client's sodium intake.
• D. Decrease the client's carbohydrate intake.

Correct answer: D

Rationale: In a client with cirrhosis and ascites, decreasing carbohydrate intake is essential as it helps reduce the production of ascitic fluid. Excess carbohydrates can lead to fluid retention. Choices A, B, and C are incorrect. Decreasing fluid intake can worsen dehydration, increasing saturated fat intake is not recommended due to its impact on liver health, and increasing sodium intake can worsen fluid retention and exacerbate ascites in these clients.

2. Cocaine is derived from the leaves of coca plant; the nurse knows that cocaine is classified as:

• A. Narcotic
• B. Stimulant
• C. Barbiturate
• D. Hallucinogen

Correct answer: A

Rationale: Patient safety and efficacy of care depend on actions rooted in established nursing protocols that consider both the immediate and long-term needs of the patient.

3. A healthcare professional is reviewing the lab findings of a client who has Clostridium Difficile. Which of the following findings should indicate to the healthcare professional that the client is experiencing Fluid Volume Deficit?

• A. Hct 53%
• B. Potassium 3.5
• C. Sodium 145
• D. HbA1c 5

Correct answer: A

Rationale: An elevated hematocrit level (Hct 53%) indicates hemoconcentration, a sign of fluid volume deficit. Hct measures the percentage of red blood cells in the blood and increases when there is a decrease in plasma volume, as seen in fluid volume deficit. Choices B, C, and D do not directly relate to fluid volume status. Potassium and sodium levels are more indicative of electrolyte imbalances, while HbA1c reflects average blood sugar levels over the past 2-3 months and is not specific to fluid volume status.

4. How many diet-related major risk factors for coronary heart disease does Mrs. Winslow have?

• A. 1
• B. 4
• C. 2
• D. 3

Correct answer: B

Rationale: Mrs. Winslow has four major diet-related risk factors for coronary heart disease: high total cholesterol, high LDL cholesterol, high triglycerides, and low HDL cholesterol. Choice A is incorrect because there are more than one risk factor present. Choices C and D are incorrect as they do not account for the total number of diet-related major risk factors identified.

5. A healthcare professional is reviewing the laboratory findings of a client who has heart failure. Which of the following findings indicates that the client is experiencing fluid volume excess?

• A. BUN 8 mg/dL
• B. Hgb 15 g/dL
• C. Creatinine 0.8 mg/dL
• D. Sodium 140 mEq/L

Correct answer: A

Rationale: A BUN level of 8 mg/dL indicates fluid volume excess in a client with heart failure. BUN (Blood Urea Nitrogen) levels can be low in fluid overload due to hemodilution, a common occurrence in heart failure. High levels of BUN usually indicate dehydration or impaired renal function, which are not the case in fluid volume excess. Choices B, C, and D are within normal ranges and do not specifically indicate fluid volume excess.

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