Nursing Elites

1. A nurse is assisting with meal planning for a client who has been prescribed a mechanical soft diet. The nurse should instruct the client to avoid which of the following foods?

• A. Applesauce
• B. Mashed potatoes
• C. Orange slices
• D. Soft bread

Correct answer: C

Rationale: The correct answer is C: Orange slices. Orange slices contain membranes that are difficult to swallow, which can pose a risk to clients on a mechanical soft diet. This type of diet is designed for individuals who have difficulty chewing or swallowing. Choices A, B, and D are suitable for a mechanical soft diet as they are soft in texture and easy to chew and swallow.

2. A client with rheumatoid arthritis is taking prednisone. Which of the following findings should the nurse identify as an adverse effect of this medication?

• A. Weight loss
• B. Hypoglycemia
• C. Hypertension
• D. Hyperkalemia

Correct answer: C

Rationale: The correct answer is C: Hypertension. Prednisone, a corticosteroid, can lead to hypertension as an adverse effect. Prednisone can cause sodium and water retention, leading to increased blood pressure. Options A, B, and D are incorrect. Weight loss is not typically associated with prednisone use; instead, weight gain is more common. Hypoglycemia is not a common adverse effect of prednisone; in fact, it can elevate blood sugar levels. Hyperkalemia is also not a typical adverse effect of prednisone; instead, it can cause hypokalemia, or low potassium levels.

3. A healthcare professional is assessing a client in the PACU. Which finding indicates decreased cardiac output?

• A. Shivering
• B. Oliguria
• C. Bradypnea
• D. Constricted pupils

Correct answer: B

Rationale: The correct answer is B: Oliguria. Oliguria (low urine output) is a sign of decreased cardiac output because the kidneys are not receiving enough blood to produce an adequate amount of urine. Shivering (choice A) is a response to hypothermia or the body's attempt to generate heat. Bradypnea (choice C) refers to abnormally slow breathing rate and is not directly related to cardiac output. Constricted pupils (choice D) are more indicative of conditions affecting the nervous system or medications.

4. A client at risk for coronary artery disease seeks advice from a nurse. What should the nurse recommend to reduce the risk?

• A. Increase your intake of saturated fats.
• B. Exercise for 150 minutes per week.
• C. Take iron supplements daily.
• D. Limit fruits and vegetables in your diet.

Correct answer: B

Rationale: The correct recommendation to reduce the risk of coronary artery disease is to exercise for at least 150 minutes per week. Regular exercise is crucial in maintaining cardiovascular health and reducing the chances of developing heart disease. Increasing intake of saturated fats (Choice A) is counterproductive as it can raise cholesterol levels and contribute to arterial plaque formation. Taking iron supplements daily (Choice C) is not directly related to reducing the risk of coronary artery disease. Limiting fruits and vegetables in the diet (Choice D) is also not advisable, as they are essential components of a heart-healthy diet due to their high fiber and nutrient content.

5. A client with a permanent spinal cord injury is scheduled for discharge. Which of the following client statements indicates that the client is coping effectively?

• A. “I would like to play wheelchair basketball. When I get stronger, I think I’ll look for a league.”
• B. “I’m glad I’ll only be in this wheelchair temporarily. I can’t wait to get back to running.”
• C. “I’m so upset that this happened to me. What did I do to deserve this, and why am I not getting better?”
• D. “I feel like I’ll never be able to do anything that I want to again. All I am is a burden to my family.”

Correct answer: A

Rationale: Choice A is the correct answer. This statement demonstrates effective coping as the client is showing acceptance of their disability and planning for the future with realistic goals. Choice B reflects denial of the permanent disability by stating that they will only be in a wheelchair temporarily. Choice C shows distress and a lack of acceptance by questioning why the injury happened and why they are not improving. Choice D indicates feelings of hopelessness and being a burden, which are not signs of effective coping.

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