Nursing Elites

1. Which lab test is used to assess renal function?

• A. Check blood glucose levels
• B. Monitor serum creatinine
• C. Monitor BUN
• D. Check electrolyte levels

Correct answer: B

Rationale: The correct answer is B: Monitor serum creatinine. Serum creatinine is a key indicator of renal function as it reflects the glomerular filtration rate. An increase in serum creatinine levels indicates impaired kidney function. Checking blood glucose levels (choice A) is not specific to assessing renal function but is used to diagnose diabetes. Monitoring BUN (choice C) is important but not as specific as serum creatinine in assessing renal function. Checking electrolyte levels (choice D) is essential in assessing kidney function but is not as specific as monitoring serum creatinine.

2. A client with a new diagnosis of peptic ulcer disease is receiving teaching from a nurse. Which of the following statements by the client indicates an understanding of the teaching?

• A. I will avoid taking ibuprofen for my pain.
• B. I will avoid eating spicy foods.
• C. I will limit my intake of dairy products.
• D. I will take my antacids 30 minutes before meals.

Correct answer: B

Rationale: The correct answer is B. Clients with peptic ulcer disease should avoid spicy foods as they can exacerbate symptoms and delay healing. Ibuprofen can worsen peptic ulcers by irritating the stomach lining, so it should be avoided. While limiting dairy products may be beneficial for some individuals with lactose intolerance, it is not a specific recommendation for peptic ulcer disease. Taking antacids before meals can help neutralize stomach acid; however, the timing may vary depending on the type of antacid, so there is no universal rule of taking antacids 30 minutes before meals. Choice A is incorrect because the client should avoid taking ibuprofen due to its potential to worsen peptic ulcers. Choice C is incorrect as there is no direct correlation between dairy product intake and peptic ulcer disease. Choice D is incorrect because the timing of antacid administration can vary and should be guided by specific recommendations.

3. When discussing clients designating a health care proxy in situations requiring a durable power of attorney for health care (DPAHC), what information should the charge nurse include?

• A. The proxy should make health care decisions for the client regardless of the client's ability to do so.
• B. The proxy can make financial decisions if the need arises.
• C. The proxy can make treatment decisions if the client is under anesthesia.
• D. The proxy should manage legal issues for the client.

Correct answer: C

Rationale: The correct answer is C. The charge nurse should include information that the proxy can make treatment decisions if the client is under anesthesia. This is a key function of a durable power of attorney for health care. Choices A, B, and D are incorrect because a health care proxy's role is specifically related to making health care decisions, not financial decisions, legal issues, or decisions made under anesthesia.

4. A nurse is preparing to perform tracheostomy care for a client. Which of the following actions should the nurse take first?

• A. Apply a sterile dressing.
• B. Suction the tracheostomy.
• C. Remove the inner cannula.
• D. Clean the stoma with sterile saline.

Correct answer: B

Rationale: Suctioning the tracheostomy should be performed first to clear the airway of secretions and ensure proper oxygenation before proceeding with other care. This helps maintain a patent airway and prevent complications such as aspiration. Applying a sterile dressing, removing the inner cannula, or cleaning the stoma can follow after ensuring adequate airway clearance through suctioning.

5. A nurse is caring for a client who has pneumonia and is receiving oxygen therapy. Which of the following findings indicates the need for suctioning?

• A. Increased respiratory rate.
• B. Oxygen saturation 96%.
• C. Clear lung sounds.
• D. Productive cough.

Correct answer: A

Rationale: The correct answer is A: Increased respiratory rate. An increased respiratory rate suggests the client is having difficulty clearing secretions and may require suctioning. Oxygen saturation of 96% is within the normal range and indicates adequate oxygenation. Clear lung sounds suggest good air entry without the need for suctioning. A productive cough, although a symptom of pneumonia, does not directly indicate the need for suctioning.

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