Nursing Elites

1. A client with gastroesophageal reflux disease (GERD) reports frequent heartburn. What dietary modification should the nurse recommend?

• A. Avoid eating large meals late at night.
• B. Eat a high-fat diet to buffer stomach acid.
• C. Reduce fluid intake to prevent acid reflux.
• D. Consume spicy foods to neutralize stomach acid.

Correct answer: A

Rationale: The correct answer is to recommend avoiding eating large meals late at night. This dietary modification can help reduce the risk of acid reflux, which can exacerbate GERD symptoms. Consuming smaller, more frequent meals is generally recommended to minimize pressure on the lower esophageal sphincter. Choice B is incorrect because a high-fat diet can worsen GERD symptoms by delaying stomach emptying. Choice C is incorrect because reducing fluid intake can lead to dehydration and will not prevent acid reflux. Choice D is incorrect because spicy foods can actually trigger or worsen acid reflux symptoms in individuals with GERD.

2. The nurse is providing discharge teaching to a client with newly diagnosed hypertension. Which lifestyle modification should the nurse emphasize to the client?

• A. Increase sodium intake to improve fluid balance
• B. Engage in regular physical activity
• C. Increase caffeine intake to improve energy
• D. Reduce potassium intake to lower blood pressure

Correct answer: B

Rationale: Engaging in regular physical activity is a crucial lifestyle modification for managing hypertension. Regular exercise helps improve cardiovascular health, lower blood pressure, and contribute to overall well-being. Choices A, C, and D are incorrect. Increasing sodium intake is not recommended for hypertension as it can worsen fluid retention and elevate blood pressure. Increasing caffeine intake is also not advised as it may lead to increased heart rate and blood pressure. Reducing potassium intake is not beneficial as potassium is essential for maintaining healthy blood pressure levels.

3. A client with a history of type 2 diabetes is admitted with hyperglycemia. What is the nurse's priority action?

• A. Administer a dose of insulin as prescribed.
• B. Check the client's blood glucose level.
• C. Administer a fluid bolus to improve hydration.
• D. Monitor the client's intake and output closely.

Correct answer: B

Rationale: The correct answer is to check the client's blood glucose level. This is the priority action when dealing with a client admitted with hyperglycemia. Checking the blood glucose level helps determine the severity of hyperglycemia and guides further treatment. Administering insulin or fluids or monitoring intake and output are important interventions but should come after assessing the blood glucose level to inform the most appropriate course of action.

4. A client is admitted for first and second-degree burns on the face, neck, anterior chest, and hands. The nurse's priority should be

• A. Cover the areas with dry sterile dressings
• B. Assess for dyspnea or stridor
• C. Initiate intravenous therapy
• D. Administer pain medication

Correct answer: B

Rationale: Assessing for dyspnea or stridor is crucial as these are signs of airway compromise, which is a priority concern in burns involving the face. Burns on the face can lead to airway swelling or compromise due to airway proximity, making respiratory assessment the top priority. Covering the areas with dry sterile dressings, initiating intravenous therapy, and administering pain medication are important interventions but assessing for airway issues takes precedence in this situation.

5. On admission to the Emergency Department, a female client who was diagnosed with bipolar disorder 3 years ago reports that this morning, she took a handful of medications and left a suicide note for her family. Which information is most important for the nurse to obtain?

• A. Client's current mood and affect
• B. When the client last took medications for bipolar disorder
• C. History of previous suicide attempts
• D. Details of the medications ingested

Correct answer: D

Rationale: Determining the specific medications ingested is the priority for guiding immediate treatment in the Emergency Department. Knowing when the client last took medications and her current mood are also important, but the ingested medications are the most urgent information needed. The client's current mood and affect are crucial for assessing her immediate state, but the priority is to identify the substances she ingested to provide appropriate interventions. While understanding the history of previous suicide attempts is relevant for assessing the client's risk, the immediate focus should be on the medications taken during this specific incident.

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