Nursing Elites

1. A client with an oversecretion of renin has a health history reviewed by a nurse. Which disorder should the nurse correlate with this assessment finding?

• A. Alzheimer’s disease
• B. Hypertension
• C. Diabetes mellitus
• D. Viral hepatitis

Correct answer: B

Rationale: Renin is secreted in response to low blood volume, blood pressure, or blood sodium levels. Excessive renin secretion can lead to persistent hypertension. Renin plays no role in Alzheimer's disease, diabetes mellitus, or viral hepatitis. Therefore, the correct correlation with oversecretion of renin is hypertension.

2. Which of the following conditions is most commonly associated with a high risk of stroke?

• A. Hypertension.
• B. Diabetes.
• C. Obesity.
• D. Smoking.

Correct answer: A

Rationale: Hypertension is the correct answer. Hypertension, also known as high blood pressure, is a major risk factor for stroke because it puts increased pressure on blood vessels in the brain, making them more prone to damage and increasing the likelihood of a stroke. While diabetes, obesity, and smoking are also risk factors for stroke, hypertension is the most commonly associated condition with a high risk of stroke due to its direct impact on the blood vessels.

3. The nurse is monitoring a client who is receiving continuous ambulatory peritoneal dialysis. The nurse should notify the physician of which of the following findings?

• A. Clear dialysate outflow.
• B. Cloudy dialysate outflow.
• C. Decreased urine output.
• D. Increased blood pressure.

Correct answer: B

Rationale: Cloudy dialysate outflow is an indication of peritonitis, a serious complication of peritoneal dialysis that requires immediate medical attention. Clear dialysate outflow is a normal finding indicating proper dialysis function and should not raise concern. Decreased urine output may be expected in a client undergoing dialysis due to the removal of excess fluids from the body. Increased blood pressure is a common complication in clients with kidney disease but is not directly related to cloudy dialysate outflow.

4. A nurse is assessing the status of a client with diabetes mellitus. The nurse concludes that the client is exhibiting adequate diabetic control if the serum level of glycosylated hemoglobin A1C (HbA1C) is less than:

• A. 7%
• B. 9%
• C. 10%
• D. 15%

Correct answer: A

Rationale: The correct answer is A: 7%. Glycosylated hemoglobin A1C (HbA1C) level of 7.0% or less is considered indicative of adequate diabetic control. This level reflects good long-term blood sugar management. Choices B, C, and D are incorrect because an HbA1C level above 7% indicates poor diabetic control and an increased risk of complications associated with diabetes, such as cardiovascular disease, neuropathy, and retinopathy.

5. A postmenopausal client asks the nurse why she is experiencing discomfort during intercourse. What response is best for the nurse to provide?

• A. Estrogen deficiency causes the vaginal tissues to become dry and thinner.
• B. Infrequent intercourse results in the vaginal tissues losing their elasticity.
• C. Dehydration from inadequate fluid intake causes vulva tissue dryness.
• D. Lack of adequate stimulation is the most common reason for dyspareunia.

Correct answer: A

Rationale: Estrogen deficiency in postmenopausal clients leads to a decrease in the moisture-secreting capacity of vaginal cells. This results in vaginal tissues becoming thinner, drier, and smoother, which reduces vaginal stretching and contributes to discomfort during intercourse. Choice B is incorrect because the primary reason for discomfort is not infrequent intercourse but rather physiological changes due to estrogen deficiency. Choice C is incorrect as dehydration may cause dryness but is not the primary reason for discomfort in this scenario. Choice D is incorrect as lack of stimulation is not the most common reason for dyspareunia in postmenopausal clients; estrogen deficiency is the key factor.

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