Nursing Elites

1. The nurse is reviewing the laboratory results of a client with chronic kidney disease. The client's serum calcium level is 7.5 mg/dL. Which condition should the nurse suspect?

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

Correct answer: D

Rationale: A serum calcium level of 7.5 mg/dL is indicative of hypocalcemia, a common complication in clients with chronic kidney disease due to impaired calcium absorption and metabolism. Hypercalcemia (Choice A) is the opposite of the condition presented in the question and is characterized by elevated serum calcium levels. Hyperkalemia (Choice B) is an increased potassium level, not related to the client's serum calcium level. Hyponatremia (Choice C) is a decreased sodium level and is also not related to the client's serum calcium level.

2. A client with cirrhosis is receiving lactulose. What is the most important assessment for the nurse to monitor?

• A. Monitor the client's ammonia levels.
• B. Monitor the client's blood glucose level.
• C. Monitor the client's potassium levels.
• D. Monitor the client's level of consciousness.

Correct answer: D

Rationale: The correct answer is to monitor the client's level of consciousness. Lactulose is used to reduce ammonia levels in hepatic encephalopathy. Monitoring the level of consciousness helps assess the effectiveness of lactulose therapy in improving the client's condition. Monitoring ammonia levels (choice A) is important, but assessing the client's response to therapy through their level of consciousness is more crucial. Blood glucose levels (choice B) and potassium levels (choice C) are not directly related to lactulose therapy for cirrhosis and hepatic encephalopathy.

3. A client with tuberculosis is prescribed rifampin. What side effect should the nurse inform the client about?

• A. Report orange-colored urine as a sign of kidney dysfunction.
• B. Expect red-orange discoloration of urine as a harmless side effect.
• C. Monitor for signs of liver toxicity.
• D. Call the healthcare provider if vision changes occur.

Correct answer: B

Rationale: The correct answer is B. Rifampin can cause red-orange discoloration of bodily fluids, including urine, saliva, and tears. This is a harmless side effect, but clients should be informed beforehand to prevent alarm. Choice A is incorrect as orange-colored urine is not a sign of kidney dysfunction related to rifampin. Choice C is incorrect because rifampin is more commonly associated with liver toxicity rather than kidney dysfunction. Choice D is incorrect as vision changes are not a typical side effect of rifampin.

4. A client with cirrhosis is admitted with jaundice, fatigue, and a distended abdomen. Which laboratory result is most important for the nurse to monitor?

• A. Ammonia level
• B. White blood cell count
• C. Albumin level
• D. Hemoglobin level

Correct answer: A

Rationale: Corrected Rationale: In clients with cirrhosis, elevated ammonia levels can lead to hepatic encephalopathy, which is a serious complication. Monitoring ammonia levels is crucial to assess for changes in mental status and initiate treatment if needed. White blood cell count (choice B) is not the most important parameter to monitor in this scenario as it does not directly relate to the complications of cirrhosis. Albumin level (choice C) and hemoglobin level (choice D) are also important in cirrhosis, but in this case, monitoring ammonia level takes precedence due to its direct association with hepatic encephalopathy.

5. The nurse is caring for a client with chronic obstructive pulmonary disease (COPD) who is receiving oxygen therapy. Which assessment finding indicates that the client's oxygenation is improving?

• A. Pulse oximetry reading of 94%
• B. Heart rate increases from 80 to 90 beats per minute
• C. Respiratory rate increases from 16 to 20 breaths per minute
• D. Client reports increased energy levels

Correct answer: A

Rationale: A pulse oximetry reading of 94% indicates adequate oxygenation. Monitoring oxygen saturation is the most objective way to assess the effectiveness of oxygen therapy. Choices B, C, and D do not directly reflect the client's oxygenation status. An increase in heart rate or respiratory rate may indicate increased work of breathing or stress on the body. The client reporting increased energy levels is subjective and may not directly correlate with improved oxygenation.

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