Nursing Elites

1. A nurse is planning care for a client who is receiving total parenteral nutrition (TPN). Which of the following laboratory values should the nurse monitor to evaluate the effectiveness of the therapy?

• A. Serum calcium level
• B. Blood glucose level
• C. Serum albumin level
• D. Serum sodium level

Correct answer: C

Rationale: The correct answer is C, Serum albumin level. Monitoring the serum albumin level helps assess the nutritional effectiveness of total parenteral nutrition (TPN). Serum albumin is a protein that reflects the long-term nutritional status of a patient. Serum calcium level (choice A) is not directly related to TPN effectiveness. Blood glucose level (choice B) is important to monitor in diabetic patients but is not the primary indicator of TPN efficacy. Serum sodium level (choice D) is more related to fluid balance and electrolyte status rather than the effectiveness of TPN.

2. A client is receiving brachytherapy for the treatment of prostate cancer. Which of the following actions should the nurse take?

• A. Cleanse equipment before removal from the client's room
• B. Limit the client's visitors to 30 minutes per day
• C. Discard the client's linens in a double bag
• D. Discard the radioactive source in a biohazard bag

Correct answer: B

Rationale: The correct action the nurse should take when caring for a client receiving brachytherapy is to limit the client's visitors to 30 minutes per day. This is crucial to reduce exposure to radiation and maintain safety during the brachytherapy procedure. Cleansing equipment before removal from the client's room may be important for infection control but is not directly related to brachytherapy procedures. Discarding the client's linens in a double bag and discarding the radioactive source in a biohazard bag are incorrect choices as they do not specifically address the safety measures needed during brachytherapy for prostate cancer.

3. A healthcare professional is assessing a client who has chronic kidney disease. Which of the following findings is an indication for hemodialysis?

• A. BUN 16 mg/dL
• B. Serum magnesium 1.8 mg/dL
• C. Serum phosphorus 4.0 mg/dL
• D. Glomerular filtration rate of 14 mL/min

Correct answer: D

Rationale: A glomerular filtration rate of 14 mL/min indicates severe kidney impairment and the need for hemodialysis. The other choices, such as BUN 16 mg/dL, serum magnesium 1.8 mg/dL, and serum phosphorus 4.0 mg/dL, are within normal ranges and do not directly indicate the need for hemodialysis in chronic kidney disease.

4. A healthcare professional is reviewing the laboratory values of a client who has cirrhosis. Which of the following findings should the healthcare professional report to the provider?

• A. Ammonia 75 mcg/dL
• B. Sodium 142 mEq/L
• C. Calcium 9.5 mg/dL
• D. Bilirubin 2.5 mg/dL

Correct answer: D

Rationale: An elevated bilirubin level in clients with cirrhosis indicates worsening liver function and potential complications. It is crucial to report this finding promptly as it may require immediate medical intervention. Elevated ammonia levels (choice A) are also concerning in cirrhosis, indicating hepatic encephalopathy, but bilirubin levels are more specific to liver function in this context. Choices B and C are within normal ranges and are not typically of immediate concern in cirrhosis.

5. A nurse is assessing a client who is at 34 weeks of gestation and has gestational hypertension. Which of the following findings should the nurse report to the provider?

• A. Blood pressure of 140/90 mm Hg
• B. Fasting blood glucose of 120 mg/dL
• C. Urinary output of 40 mL/hr
• D. Weight gain of 2.3 kg (5 lb) in 1 week

Correct answer: D

Rationale: A weight gain of 2.3 kg (5 lb) in 1 week can indicate worsening gestational hypertension and should be reported to the provider. Sudden weight gain in a client with gestational hypertension can be a sign of fluid retention, which could worsen the hypertension and lead to complications like preeclampsia. The other options, blood pressure of 140/90 mm Hg, fasting blood glucose of 120 mg/dL, and urinary output of 40 mL/hr, are within normal limits for a client with gestational hypertension and do not pose an immediate concern that requires reporting to the provider.

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