Nursing Elites

1. A client receiving chemotherapy reports severe nausea. What should the nurse implement first?

• A. Administer an antiemetic as prescribed.
• B. Offer the client small, frequent meals.
• C. Provide the client with crackers and water.
• D. Encourage the client to eat a bland diet.

Correct answer: A

Rationale: The correct answer is A: Administer an antiemetic as prescribed. When a client receiving chemotherapy reports severe nausea, the priority action is to administer an antiemetic medication as prescribed. Antiemetics help alleviate nausea and prevent complications associated with chemotherapy, such as dehydration and malnutrition. Options B, C, and D focus on dietary interventions which can be helpful but addressing the severe nausea with antiemetic medication takes precedence to provide immediate relief and ensure the client's comfort and well-being.

2. Which foods should a healthcare provider recommend for a child with phenylketonuria (PKU) to avoid?

• A. Fresh fruit and vegetables
• B. Foods sweetened with aspartame
• C. Bread with honey
• D. Gluten-rich bread

Correct answer: B

Rationale: The correct answer is B: 'Foods sweetened with aspartame.' Children with PKU must avoid foods containing aspartame because it breaks down into phenylalanine, which can worsen their condition. Choice A, fresh fruit and vegetables, are generally healthy and safe for individuals with PKU. Choice C, bread with honey, is also safe unless the bread contains artificial sweeteners like aspartame. Choice D, gluten-rich bread, is not specifically problematic for individuals with PKU unless it contains aspartame or other substances high in phenylalanine.

3. A client with acute kidney injury (AKI) is experiencing hyperkalemia. What intervention should the nurse prioritize?

• A. Administer IV calcium gluconate.
• B. Administer sodium polystyrene sulfonate (Kayexalate).
• C. Administer insulin with dextrose.
• D. Restrict potassium intake in the client's diet.

Correct answer: A

Rationale: The correct intervention for a client with acute kidney injury (AKI) experiencing hyperkalemia is to administer IV calcium gluconate. Calcium gluconate helps stabilize the myocardium and prevent life-threatening arrhythmias in hyperkalemia by antagonizing the cardiac effects of high potassium levels. Choice B, administering sodium polystyrene sulfonate (Kayexalate), is used to lower potassium levels in the gastrointestinal tract but is not the priority in acute severe hyperkalemia. Choice C, administering insulin with dextrose, helps drive potassium into cells but is not the priority in a client at risk for arrhythmias due to hyperkalemia. Choice D, restricting potassium intake in the client's diet, is a long-term strategy but is not the immediate priority in managing acute hyperkalemia.

4. The nurse is taking the blood pressure measurement of a client with Parkinson's disease. Which information in the client's admission assessment is relevant to the nurse's plan for taking the blood pressure reading?

• A. Frequent syncope
• B. Muscle rigidity
• C. Gait instability
• D. Fine motor tremors

Correct answer: A

Rationale: The correct answer is A: 'Frequent syncope.' Orthostatic hypotension, common in Parkinson's disease, often causes syncope (fainting) when blood pressure drops upon standing. This information is critical for planning safe blood pressure measurements, ensuring readings are taken in both lying and standing positions to assess for sudden drops in pressure. Muscle rigidity, tremors, or gait instability are important symptoms in Parkinson's disease but are not directly related to blood pressure assessment.

5. A client is prescribed metformin for type 2 diabetes. What should the nurse emphasize in the client's teaching?

• A. Take the medication with meals to reduce the risk of GI upset.
• B. Report any muscle pain to the healthcare provider promptly.
• C. Avoid alcohol consumption while taking this medication.
• D. Monitor blood sugar levels regularly to prevent hypoglycemia.

Correct answer: C

Rationale: The correct answer is to avoid alcohol consumption while taking metformin. Alcohol can increase the risk of lactic acidosis when combined with metformin. Choice A is incorrect because metformin is usually recommended to be taken with meals to reduce GI upset. Choice B is important but not the priority; muscle pain is more commonly associated with other diabetes medications. Choice D is incorrect because metformin typically does not cause hypoglycemia but rather helps control blood sugar levels in type 2 diabetes.

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