Nursing Elites

1. A nurse is reviewing laboratory data for a client who has chronic kidney disease. Which of the following findings should the nurse expect?

• A. Increased creatinine
• B. Increased hemoglobin
• C. Increased bicarbonate
• D. Increased calcium

Correct answer: A

Rationale: The correct answer is A: Increased creatinine. In chronic kidney disease, the kidneys are unable to filter waste effectively, leading to a buildup of creatinine in the blood. This results in increased creatinine levels in laboratory tests. Choice B, increased hemoglobin, is not typically associated with chronic kidney disease. Choice C, increased bicarbonate, is also not a common finding in chronic kidney disease; in fact, metabolic acidosis with decreased bicarbonate levels is more common. Choice D, increased calcium, is not expected in chronic kidney disease; instead, calcium levels may be low due to impaired kidney function.

2. A client is postoperative following a thyroidectomy. Which of the following findings should the nurse identify as an indication of hypocalcemia?

• A. Constipation
• B. Numbness and tingling of the fingers
• C. Increased thirst
• D. Frequent urination

Correct answer: B

Rationale: Numbness and tingling of the fingers are classic signs of hypocalcemia, a condition that may result from inadvertent damage to the parathyroid glands during a thyroidectomy. These symptoms occur due to decreased levels of calcium in the bloodstream affecting nerve function. Choices A, C, and D are not typical manifestations of hypocalcemia. Constipation is more associated with hypercalcemia, increased thirst can be seen in diabetes or dehydration, and frequent urination is a symptom more commonly linked to conditions like diabetes or urinary tract issues.

3. How should a healthcare provider care for a patient who is refusing medication?

• A. Assess the reasons for refusal
• B. Explore alternative treatment options
• C. Document the refusal
• D. Discontinue the medication

Correct answer: A

Rationale: When a patient refuses medication, it is essential for the healthcare provider to assess the reasons for refusal. This allows the provider to understand the patient's concerns, provide education or clarification if needed, and work collaboratively with the patient to find a solution. Exploring alternative treatment options may be necessary after understanding the reasons behind the refusal. Documenting the refusal is important for legal and continuity of care purposes, but it is not the initial action to take. Discontinuing the medication without understanding the patient's reasons for refusal can lead to potential harm and is not a recommended approach.

4. A client with osteoporosis is being taught by a nurse about preventing bone loss. Which of the following instructions should the nurse include?

• A. Take a calcium supplement once a day.
• B. Avoid weight-bearing exercises.
• C. Walk for 30 minutes 3 times per week.
• D. Increase intake of high-phosphorus foods.

Correct answer: C

Rationale: The correct answer is C: 'Walk for 30 minutes 3 times per week.' Walking is a weight-bearing exercise that helps prevent bone loss and improve overall health in clients with osteoporosis. Option A is incorrect because while calcium is essential for bone health, simply taking a supplement is not sufficient for preventing bone loss. Option B is incorrect because weight-bearing exercises are actually beneficial for improving bone density and strength. Option D is incorrect because high-phosphorus foods do not play a significant role in preventing bone loss in osteoporosis.

5. A client with a new diagnosis of hypertension is being taught by a nurse. Which of the following statements by the client indicates an understanding of the teaching?

• A. I should avoid eating foods high in potassium.
• B. I will check my blood pressure at least once a week.
• C. I should increase my intake of dairy products.
• D. I should exercise for 30 minutes at least 5 days a week.

Correct answer: D

Rationale: The correct answer is D. Exercising for 30 minutes at least 5 days a week helps manage hypertension by promoting cardiovascular health. Statements A, B, and C are incorrect. Avoiding foods high in potassium is not necessary unless specifically advised by a healthcare provider. Checking blood pressure once a week is not frequent enough for effective monitoring. Increasing dairy product intake is not a recommended approach to managing hypertension.

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