Nursing Elites

1. A healthcare professional is assessing a client with hepatic encephalopathy. Which of the following foods indicates understanding of dietary teaching?

• A. Cottage cheese
• B. Tuna salad
• C. Rice with black beans
• D. Three-egg omelet

Correct answer: C

Rationale: The correct answer is C: 'Rice with black beans.' Plant-based proteins such as beans are recommended for clients with hepatic encephalopathy to reduce ammonia production from animal proteins. Cottage cheese (choice A), tuna salad (choice B), and a three-egg omelet (choice D) are high in animal proteins, which can contribute to increased ammonia levels in hepatic encephalopathy, making them less suitable dietary choices for these clients.

2. A healthcare professional is teaching a client about the use of methotrexate. Which of the following should be included?

• A. It is a pain reliever
• B. Monitor for signs of infection
• C. It can be taken without food
• D. It is safe to use during pregnancy

Correct answer: B

Rationale: The correct answer is B: 'Monitor for signs of infection.' Methotrexate can suppress the immune system, making the client more susceptible to infections. Educating the client to monitor for signs of infection is crucial for early detection and management. Choice A is incorrect because methotrexate is not a pain reliever; it is commonly used to treat conditions like cancer, rheumatoid arthritis, and psoriasis. Choice C is incorrect because methotrexate is usually recommended to be taken with food to reduce gastrointestinal side effects. Choice D is incorrect because methotrexate is known to be harmful during pregnancy and should not be used by pregnant individuals as it can cause birth defects.

3. A nurse is assessing a male adolescent client who has heart failure. Based on the client’s chart, which of the following actions should the nurse plan to take?

• A. Withhold spironolactone
• B. Administer ferrous sulfate
• C. Administer furosemide
• D. Withhold digoxin

Correct answer: C

Rationale: The correct answer is to administer furosemide. Furosemide is a diuretic commonly used in heart failure to manage fluid retention, helping alleviate symptoms like edema and shortness of breath. Withholding spironolactone, a potassium-sparing diuretic, could lead to electrolyte imbalances. Administering ferrous sulfate is used to treat iron deficiency anemia, not heart failure. Withholding digoxin, a medication used in heart failure to improve heart function, can worsen the client's condition.

4. A nurse is caring for a client who has been prescribed furosemide. Which of the following foods should the nurse encourage the client to include in their diet?

• A. Table salt
• B. Egg yolks
• C. White wine
• D. Oranges

Correct answer: D

Rationale: Furosemide is a potassium-wasting diuretic, so clients should consume potassium-rich foods like oranges to prevent hypokalemia. Oranges are a good source of potassium. Table salt, egg yolks, and white wine do not provide significant amounts of potassium and are not beneficial for a client taking furosemide.

5. A healthcare provider is reviewing laboratory values for a client who reports fatigue and cold intolerance. The client has an increased thyroid-stimulating hormone (TSH) level and a decreased total T3 and T4 level. The healthcare provider should anticipate a prescription for which of the following medications?

• A. Methimazole
• B. Somatropin
• C. Levothyroxine
• D. Propylthiouracil

Correct answer: C

Rationale: The client’s symptoms and lab results indicate hypothyroidism, and levothyroxine is the standard treatment to replace the deficient thyroid hormones. Methimazole and propylthiouracil are used to treat hyperthyroidism by decreasing the production of thyroid hormones. Somatropin is a growth hormone used in conditions of growth hormone deficiency, not for hypothyroidism.

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