Nursing Elites

1. A healthcare provider is reviewing the laboratory data of a client who is receiving total parenteral nutrition. Which of the following findings should the healthcare provider report?

• A. Serum calcium 8.5 mg/dL
• B. Blood glucose level 120 mg/dL
• C. Serum sodium 138 mEq/L
• D. Serum albumin 3.5 g/dL

Correct answer: D

Rationale: The correct answer is D: Serum albumin 3.5 g/dL. A low serum albumin level indicates protein deficiency, which can be a complication of TPN therapy and requires prompt intervention. The other laboratory findings provided (serum calcium 8.5 mg/dL, blood glucose level 120 mg/dL, and serum sodium 138 mEq/L) are within normal ranges and do not specifically indicate complications related to TPN therapy.

2. A client with a new diagnosis of diabetes mellitus is being taught about foot care by a nurse. Which of the following instructions should the nurse include?

• A. Soak your feet in warm water every day to prevent dryness.
• B. Trim your toenails straight across to prevent injury.
• C. Apply lotion between your toes after bathing.
• D. Wear cotton socks to keep your feet dry.

Correct answer: B

Rationale: The correct answer is B: 'Trim your toenails straight across to prevent injury.' In clients with diabetes, trimming toenails straight across is essential to prevent ingrown toenails and injury. Choice A is incorrect because soaking feet in warm water can lead to dryness, which is not recommended for diabetic foot care. Choice C is incorrect as applying lotion between the toes can create excess moisture, increasing the risk of fungal infections. Choice D is incorrect because although cotton socks are recommended, the primary purpose is to prevent moisture buildup, not specifically to keep the feet dry.

3. A nurse is preparing to teach a client about the use of a peak flow meter. Which of the following instructions should the nurse include?

• A. Place the mouthpiece in your mouth and blow out as quickly as you can.
• B. Exhale slowly into the mouthpiece over 5 seconds.
• C. Take a slow deep breath before blowing into the mouthpiece.
• D. Blow into the mouthpiece at a steady rate for 3 seconds.

Correct answer: A

Rationale: The correct instruction for using a peak flow meter is to place the mouthpiece in your mouth and blow out as quickly as you can. This action helps measure the peak expiratory flow of the client. Choice B is incorrect because exhaling slowly does not provide an accurate peak flow reading. Choice C is incorrect as taking a slow deep breath before blowing interferes with obtaining an accurate measurement. Choice D is incorrect as blowing at a steady rate for 3 seconds may not reflect the peak expiratory flow accurately.

4. A client who is at 28 weeks of gestation is being taught by a nurse about managing heartburn. Which of the following instructions should the nurse include?

• A. Eat small, frequent meals.
• B. Drink a glass of milk with each meal.
• C. Lie down after meals.
• D. Drink plenty of fluids with meals.

Correct answer: A

Rationale: The correct instruction for managing heartburn during pregnancy is to eat small, frequent meals. This helps prevent heartburn by reducing gastric distention. Option B, drinking a glass of milk with each meal, may exacerbate heartburn in some individuals due to its fat content. Option C, lying down after meals, can worsen heartburn as it allows stomach acid to flow back into the esophagus. Option D, drinking plenty of fluids with meals, can also contribute to heartburn by distending the stomach. Therefore, the best advice for managing heartburn during pregnancy is to eat small, frequent meals.

5. A nurse in an emergency department completes an assessment on an adolescent client with conduct disorder. The client threatened suicide to a teacher at school. Which of the following statements should the nurse include in the assessment?

• A. Tell me about your siblings
• B. Tell me what kind of music you like
• C. Tell me how often you drink alcohol
• D. Tell me about your school schedule

Correct answer: C

Rationale: Asking about alcohol intake is crucial in assessing the client's risk factors and behaviors, especially in the context of a suicide threat. Understanding alcohol consumption patterns can help the nurse evaluate potential substance abuse issues and their impact on the client's mental health. Choices A, B, and D are less pertinent to the immediate concern of assessing suicide risk and conduct disorder symptoms.

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