Nursing Elites

1. The parish nurse notes that an elderly male client has had a 5 lbs weight loss since his check-up one month ago. The client has good hygiene, still drives a car, and lives alone. To which agency should the nurse refer this client?

• A. the adult day care center
• B. the social security administration office
• C. the women, infants, and children office
• D. the senior citizen center

Correct answer: D

Rationale: The correct answer is 'D: the senior citizen center.' In this scenario, the elderly male client is experiencing unexplained weight loss, which could be indicative of underlying health issues or social isolation. Referring him to the senior citizen center is appropriate as it can provide social support, resources, and programs tailored to address the client's weight loss and overall well-being. Choice A, the adult day care center, is not the most suitable option as the client is still independent and living alone. Choice B, the social security administration office, and Choice C, the women, infants, and children office, are not relevant in this context and do not address the client's specific needs related to weight loss and social support.

2. The nurse is providing care for a client with syndrome of inappropriate antidiuretic hormone (SIADH). Which laboratory result requires immediate intervention?

• A. Serum sodium of 140 mEq/L.
• B. Serum potassium of 4.5 mEq/L.
• C. Serum osmolality of 280 mOsm/kg.
• D. Serum sodium of 130 mEq/L.

Correct answer: D

Rationale: The correct answer is D: Serum sodium of 130 mEq/L. In SIADH, there is excess release of antidiuretic hormone leading to water retention and dilutional hyponatremia. A serum sodium level of 130 mEq/L indicates severe hyponatremia, which can result in neurological symptoms, such as confusion, seizures, and coma. Therefore, immediate intervention is required to prevent further complications. Choice A, a serum sodium of 140 mEq/L, is within the normal range and does not require immediate intervention. Choice B, serum potassium of 4.5 mEq/L, is also within the normal range and is not directly related to SIADH. Choice C, serum osmolality of 280 mOsm/kg, is a measure of the concentration of solutes in the blood and may not be the most critical parameter to address in a client with SIADH and severe hyponatremia.

3. The nurse is caring for a client with a nasogastric tube to continuous suction. Which electrolyte imbalance should the nurse monitor for?

• A. Hypercalcemia.
• B. Hypokalemia.
• C. Hyponatremia.
• D. Hypomagnesemia.

Correct answer: B

Rationale: The correct answer is B: Hypokalemia. When a client has a nasogastric tube to continuous suction, potassium loss through gastric fluids can lead to hypokalemia. Hypercalcemia (Choice A) is not typically associated with continuous suction. Hyponatremia (Choice C) involves sodium imbalance and is not directly related to nasogastric suction. Hypomagnesemia (Choice D) is not the primary concern in this situation, as potassium loss is more significant with gastric suction.

4. The client with the sexually transmitted disease HPV reports having had prior sexually transmitted infections. Which response should the nurse provide?

• A. Emphasize that using safe sex practices removes the risk of transmission.
• B. Instruct the client of the importance of notifying sexual partners.
• C. Reassure that complications will not occur if infection is treated.
• D. Provide counseling that most contraceptives prevent against infection.

Correct answer: B

Rationale: Instructing the client about the importance of notifying sexual partners is crucial when dealing with sexually transmitted infections like HPV. This helps prevent the spread of the infection to others and promotes responsible sexual behavior. Choices A, C, and D are incorrect because while using safe sex practices is important, notifying sexual partners is more immediate and directly related to preventing the spread of the infection. Reassuring about complications and discussing contraceptives do not address the immediate need to notify partners.

5. The client with liver cirrhosis needs immediate intervention for which abnormal laboratory result?

• A. Prothrombin time (PT) of 14 seconds.
• B. Bilirubin of 1.2 mg/dL.
• C. Albumin of 4 g/dL.
• D. Ammonia level of 80 mcg/dL.

Correct answer: D

Rationale: An elevated ammonia level of 80 mcg/dL indicates hepatic encephalopathy, a serious complication of liver cirrhosis that requires immediate intervention. Ammonia is a neurotoxin that accumulates in the blood due to impaired liver function, leading to cognitive impairment and altered mental status. Monitoring and lowering ammonia levels are crucial in managing hepatic encephalopathy to prevent further neurological deterioration. Prothrombin time, bilirubin, and albumin levels are important parameters in assessing liver function and overall health status in clients with liver cirrhosis, but an elevated ammonia level poses an immediate threat to neurological function and warrants prompt attention.

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