Nursing Elites

1. A healthcare professional is reviewing the laboratory findings of a client who has diabetes mellitus. Which of the following findings indicates a need to revise the client's plan of care?

• A. Serum sodium 144 mEq/L.
• B. HbA1c 10%.
• C. Random serum glucose 190 mg/dL.
• D. Creatinine 1.2 mg/dL.

Correct answer: C

Rationale: Elevated random serum glucose levels of 190 mg/dL indicate hyperglycemia and poor blood sugar control, requiring a revised plan of care. HbA1c levels above 7% also indicate long-term poor control of blood sugar. Serum sodium of 144 mEq/L and creatinine of 1.2 mg/dL are within normal ranges and do not directly indicate a need for a plan of care revision.

2. A nurse is caring for a client who has cirrhosis. Which of the following laboratory values should the nurse expect to be elevated?

• A. Serum albumin.
• B. Ammonia.
• C. Bilirubin.
• D. Prothrombin time.

Correct answer: B

Rationale: The correct answer is B: Ammonia. In clients with cirrhosis, impaired liver function can lead to elevated levels of ammonia in the blood. Elevated ammonia levels can result in hepatic encephalopathy, a condition characterized by altered mental status. Serum albumin (Choice A) is typically decreased in cirrhosis due to the liver's reduced synthetic function. Bilirubin (Choice C) levels can be elevated in liver disease but may not always be the most specific marker for cirrhosis. Prothrombin time (Choice D) is prolonged in cirrhosis due to impaired liver synthesis of clotting factors.

3. Which electrolyte imbalance is commonly seen in patients receiving furosemide?

• A. Hypokalemia
• B. Hypercalcemia
• C. Hyponatremia
• D. Hyperkalemia

Correct answer: A

Rationale: The correct answer is A: Hypokalemia. Furosemide is a loop diuretic that can lead to potassium loss, resulting in hypokalemia. This electrolyte imbalance necessitates close monitoring to prevent complications such as cardiac arrhythmias. Choices B, C, and D are incorrect. Hypercalcemia is not a common side effect of furosemide. Hyponatremia is more commonly associated with other medications like thiazide diuretics. Hyperkalemia is the opposite electrolyte imbalance and is not typically seen with furosemide use.

4. A nurse is providing dietary teaching to a client with irritable bowel syndrome (IBS). What recommendation should be included?

• A. Consume foods high in bran fiber.
• B. Increase intake of milk products.
• C. Sweeten foods with fructose corn syrup.
• D. Increase intake of foods high in gluten.

Correct answer: A

Rationale: The correct answer is A: Consume foods high in bran fiber. Bran fiber is recommended for clients with IBS as it promotes regularity and helps reduce symptoms. Choices B, C, and D are incorrect. Increasing milk products may exacerbate symptoms in some individuals with IBS due to lactose intolerance. Sweetening foods with fructose corn syrup can worsen symptoms as it is a type of sugar that can lead to gastrointestinal discomfort. Increasing intake of foods high in gluten is not recommended for individuals with IBS, especially those with gluten sensitivity, as it may trigger or worsen symptoms.

5. A healthcare provider is preparing education material for a client. Which technique should the healthcare provider use in creating the material?

• A. Emphasize important information using bold lettering.
• B. Use a 7th-grade reading level.
• C. Avoid using cartoons in the material.
• D. Use words with three or four syllables.

Correct answer: B

Rationale: Using a 7th-grade reading level is the most effective technique when creating education material for clients because it ensures that the content is easily understood by a wide range of individuals. Option A, emphasizing important information with bold lettering, may help draw attention but doesn't guarantee comprehension. Option C, avoiding cartoons, is not necessarily a universal rule and can sometimes make material more engaging. Option D, using words with three or four syllables, can make the material more complex and harder to understand, defeating the purpose of effective communication in education material.

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