Nursing Elites

1. A nurse is reviewing the laboratory results for a client who has Cushing's disease. The nurse should expect the client to have an increase in which of the following laboratory values?

• A. Serum glucose level.
• B. Serum calcium level.
• C. Lymphocyte count.
• D. Serum potassium level.

Correct answer: A

Rationale: The correct answer is A: Serum glucose level. In Cushing's disease, there is an excess production of cortisol, leading to hyperglycemia. This results in an increase in serum glucose levels. Choices B, C, and D are incorrect because Cushing's disease does not directly affect serum calcium levels, lymphocyte count, or serum potassium levels.

2. A client who is to undergo a colonoscopy is being taught by a nurse about the procedure. Which of the following statements by the client indicates an understanding of the teaching?

• A. I will drink liquids right up until the procedure.
• B. I will need to stop eating and drinking at least 24 hours before the procedure.
• C. I will be sedated and will not feel any pain during the procedure.
• D. I will not need to follow any specific dietary restrictions for this procedure.

Correct answer: C

Rationale: Choice C is the correct answer. During a colonoscopy, clients are typically sedated, so they do not feel any pain during the procedure. Choices A, B, and D are incorrect. Clients are usually required to stop eating and drinking at least 24 hours before a colonoscopy, and there are specific dietary restrictions that need to be followed before the procedure to ensure a successful examination.

3. A client with coronary artery disease (CAD) is being taught about lifestyle changes by a nurse. Which of the following instructions should the nurse include?

• A. Increase your intake of red meat
• B. Increase physical activity to 150 minutes per week
• C. Avoid foods high in fiber
• D. Increase sodium intake to 2,300 mg per day

Correct answer: B

Rationale: The correct answer is B: 'Increase physical activity to 150 minutes per week.' Increasing physical activity is essential for clients with CAD as it helps reduce the risk of cardiovascular events. Choice A is incorrect as red meat is high in saturated fats, which can be detrimental for CAD. Choice C is incorrect as foods high in fiber, such as fruits, vegetables, and whole grains, are beneficial for heart health. Choice D is incorrect as increasing sodium intake can lead to hypertension and worsen CAD.

4. What is the priority when managing a client with a chest tube postoperatively?

• A. Clamp the chest tube for 30 minutes every 4 hours
• B. Check for air leaks and proper functioning of the chest tube
• C. Encourage deep breathing and coughing every 2 hours
• D. Encourage frequent coughing to clear secretions

Correct answer: B

Rationale: The priority when managing a client with a chest tube postoperatively is to check for air leaks and ensure the proper functioning of the chest tube. This is crucial to prevent complications such as pneumothorax or hemothorax. Clamping the chest tube intermittently can lead to a buildup of pressure in the pleural space and should not be done without a specific medical indication. Encouraging deep breathing and coughing helps with lung expansion but is not the priority over ensuring the chest tube's proper function. Encouraging frequent coughing may increase the risk of dislodging the chest tube or causing complications.

5. What are the potential complications of a patient receiving hemodialysis?

• A. Infection and hypotension
• B. Pulmonary embolism and fluid overload
• C. Blood clot formation and electrolyte imbalance
• D. Low blood pressure and nausea

Correct answer: A

Rationale: Corrected Question: What are the potential complications of a patient receiving hemodialysis? Rationale: Infection and hypotension are common complications in patients undergoing hemodialysis. Pulmonary embolism and fluid overload (Choice B) are less common complications associated with hemodialysis. Blood clot formation and electrolyte imbalance (Choice C) are also potential complications but are not as common as infection and hypotension. Low blood pressure and nausea (Choice D) can occur but are not as prevalent as infection and hypotension.

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