Nursing Elites

1. The client has been taking divalproex (Depakote) for the management of bipolar disorder. The nurse should give priority to monitoring which laboratory test?

• A. Alanine aminotransferase (ALT)
• B. Serum glucose
• C. Serum creatinine
• D. Serum electrolytes

Correct answer: A

Rationale: The correct answer is Alanine aminotransferase (ALT). Monitoring ALT levels is crucial when a patient is taking divalproex (Depakote) due to the risk of drug-induced hepatitis. Elevated ALT levels indicate liver damage or disorders, which can be a side effect of Depakote. Serum glucose (choice B) is not the priority for monitoring in this case, as the medication does not directly affect glucose levels. Serum creatinine (choice C) is not the most relevant test to monitor for Depakote use; it primarily assesses kidney function. Serum electrolytes (choice D) are important but do not take precedence over monitoring ALT levels when a patient is on Depakote.

2. Which of the following statements should the nurse use to best describe a very low-calorie diet (VLCD) to a client?

• A. "This diet can be used when there is close medical supervision."?
• B. "This is a long-term treatment measure that assists obese people who can't lose weight."?
• C. "The VLCD consists of solid food items that are pureed to facilitate digestion and absorption."?
• D. "A VLCD contains very little protein."?

Correct answer: A

Rationale: The correct answer is, "This diet can be used when there is close medical supervision."? Very low-calorie diets (VLCDs) are used in the clinical treatment of obesity under close medical supervision. The diet is low in calories, high in quality protein, and has a minimum of carbohydrates to spare protein and prevent ketosis. Choice B is incorrect because VLCDs are typically short-term interventions. Choice C is incorrect because VLCDs usually consist of nutritionally complete liquid formulations, not solid food items that are pureed. Choice D is incorrect because VLCDs actually contain a high quality of protein, although the overall caloric content is very low.

3. In a client with asthma who develops respiratory acidosis, what should the nurse expect the client's serum potassium level to be?

• A. normal
• B. elevated
• C. low
• D. unrelated to the pH

Correct answer: B

Rationale: In respiratory acidosis, the serum potassium level is expected to be elevated. This occurs because potassium shifts from cells into the bloodstream as a compensatory mechanism to maintain acid-base balance. Choices A, C, and D are incorrect. A normal potassium level is not expected in respiratory acidosis. A low potassium level is more commonly associated with alkalosis, not acidosis. The potassium level is indeed related to pH changes in respiratory acidosis, leading to the expected elevation.

4. A 55-year-old female asks a nurse the following, “Which mineral/vitamin is the most important to prevent the progression of osteoporosis?” The nurse should state:

• A. Potassium
• B. Magnesium
• C. Calcium
• D. Vitamin B12

Correct answer: C

Rationale: The correct answer is C: Calcium. Calcium is essential for maintaining bone health and is crucial in preventing osteoporosis. Adequate calcium intake, along with vitamin D, is vital for bone strength. While other minerals and vitamins are also important for overall health, in the context of preventing osteoporosis, calcium plays a primary role. Potassium (Choice A), Magnesium (Choice B), and Vitamin B12 (Choice D) are important for various bodily functions but are not as directly linked to preventing osteoporosis as calcium.

5. Herbal therapy has several indications for use. Primarily, herbal therapy is:

• A. used to treat many common complaints and diseases.
• B. used to promote certain types of low-carb diets.
• C. used as an adjunct to medications.
• D. used to create a diet without salt and carbohydrates.

Correct answer: A

Rationale: The correct answer is A: 'used to treat many common complaints and diseases.' Herbal therapy is commonly used to address a variety of health issues and ailments by utilizing natural remedies derived from plants. Choices B, C, and D are incorrect because herbal therapy's primary purpose is not to promote specific diets, act as an adjunct to medications, or create specific dietary restrictions, but rather to provide alternative treatment options for various health conditions.

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