Nursing Elites

1. The nurse is assessing a client with a diagnosis of pre-renal acute kidney injury (AKI). Which condition would the nurse expect to find in the client’s recent history?

• A. Pyelonephritis
• B. Myocardial infarction
• C. Bladder cancer
• D. Kidney stones

Correct answer: B

Rationale: In pre-renal acute kidney injury, there is a decrease in perfusion to the kidneys. Myocardial infarction can lead to decreased blood flow to the kidneys, causing pre-renal AKI. Pyelonephritis is an intrinsic/intrarenal cause of AKI involving kidney damage. Bladder cancer and kidney stones are post-renal causes of AKI due to urinary flow obstruction, not related to perfusion issues seen in pre-renal AKI.

2. In assessing cancer risk, which woman is at greatest risk of developing breast cancer?

• A. A 35-year-old multipara who never breastfed.
• B. A 50-year-old whose mother had unilateral breast cancer.
• C. A 55-year-old whose mother-in-law had bilateral breast cancer.
• D. A 20-year-old whose menarche occurred at age 9.

Correct answer: B

Rationale: The correct answer is B because family history of breast cancer, specifically in the mother, is a significant risk factor for developing breast cancer. The age of 50 is also a risk factor for breast cancer. Choice A is less likely as breastfeeding can actually reduce the risk of breast cancer. Choice C is less relevant since the risk is higher with a direct family member. Choice D, although early menarche is a risk factor, the age of the individual is much lower compared to the other age-related risk factors.

3. A 70-kg adult with chronic renal failure is on a 40-g protein diet. The client has a reduced glomerular filtration rate and is not undergoing dialysis. Which result would give the nurse the most concern?

• A. Albumin level of 2.5 g/dL
• B. Phosphorus level of 5 mg/dL
• C. Sodium level of 135 mmol/L
• D. Potassium level of 5.5 mmol/L

Correct answer: A

Rationale: In chronic renal failure, a protein-restricted diet is crucial to prevent the buildup of waste products. A low albumin level (<3.5 g/dL) indicates inadequate protein intake, raising concern as it may lead to malnutrition and tissue breakdown. Phosphorus, sodium, and potassium levels are not directly impacted by protein intake. Phosphorus levels may elevate in renal failure, but at 5 mg/dL, it is within normal range. Sodium and potassium levels are also within normal limits and not influenced by protein restriction.

4. A client with autosomal dominant polycystic kidney disease (ADPKD) asks, “Will my children develop this disease?” How should the nurse respond?

• A. No genetic link is known, so your children are not at increased risk.
• B. Your sons will develop this disease because it has a sex-linked gene.
• C. Only if both you and your spouse are carriers of this disease.
• D. Each of your children has a 50% risk of having ADPKD.

Correct answer: D

Rationale: Children whose parent has the autosomal dominant form of PKD have a 50% chance of inheriting the gene that causes the disease. ADPKD is transmitted as an autosomal dominant trait and therefore is not gender-specific. Both parents do not need to have this disorder. Choice A is incorrect because ADPKD has a known genetic link and a definitive mode of inheritance. Choice B is incorrect as ADPKD is not sex-linked but autosomal dominant. Choice C is incorrect because ADPKD follows an autosomal dominant inheritance pattern and does not require both parents to be carriers for the child to inherit the disease.

5. A client's laboratory findings indicate elevations in thyroxine and triiodothyronine hormones. The nurse suspects that the client may have hyperthyroidism. Which assessment finding is most often associated with hyperthyroidism?

• A. Periorbital edema.
• B. Atrophied thyroid gland.
• C. Increased pulse rate.
• D. Diarrhea stools.

Correct answer: C

Rationale: Increased pulse rate is commonly associated with hyperthyroidism due to the increased metabolic rate. Periorbital edema (Choice A) is more commonly associated with conditions like nephrotic syndrome or heart failure, not hyperthyroidism. Atrophied thyroid gland (Choice B) is not typically an assessment finding for hyperthyroidism as the gland is usually enlarged in this condition. Diarrhea stools (Choice D) can occur in hyperthyroidism, but it is not the most common assessment finding associated with the condition.

Similar Questions