NCLEX-RN® Examination, 7th Edition (Medical-Surgical ) 2024

1.The nurse notes that a client who is scheduled for surgery the next morning has an elevated blood urea nitrogen (BUN) level. Which condition is most likely to have contributed to this finding? Correct Answer A Myocardial infarction 2 months ago B Anorexia and vomiting for the past 2 days C Recently diagnosed type 2 diabetes mellitus D Skeletal traction for a right hip fracture Rationale: The blood urea nitrogen (BUN) level indicates the effectiveness of the kidneys in filtering waste from the blood. Dehydration, which could be caused by vomiting, would cause an increased BUN level. Option A would affect serum enzyme levels, not the BUN level. Option C would primarily affect the blood glucose level; renal failure that could increase the BUN level would be unlikely in a client newly diagnosed with type 2 diabetes. Effects of option D might affect the complete blood count (CBC) but would not directly increase the BUN level. 1. A 55-year-old male client has been admitted to the hospital with a medical diagnosis of chronic obstructive pulmonary disease (COPD). Which risk factor is the most significant in the development of this client’s COPD? Correct Answer A The client’s father was diagnosed with COPD in his 50s. B A close family member contracted tuberculosis last year. C The client smokes one to two packs of cigarettes per day. D The client has been 40 pounds overweight for 15 years. Rationale: Smoking, considered to be a modifiable risk factor, is the most significant risk factor for the development of COPD. The exact mechanism of genetic and hereditary implications for the development of COPD is still under investigation, although exposure to similar predisposing factors (e.g. smoking or inhaling secondhand smoke) may increase the likelihood of COPD incidence among family members. Options B and D do not exceed the risks associated with cigarette smoking in the development of COPD. 2. The nurse is caring for a client with a fractured right elbow. Which assessment finding has the