Nursing Elites

1. What action should the healthcare provider take for a patient with a chest tube?

• A. Strip the drainage tubing every 4 hours.
• B. Keep the drainage system below the level of the patient's chest.
• C. Clamp the chest tube when ambulating the patient.
• D. Ensure the water seal chamber is filled to the prescribed level.

Correct answer: D

Rationale: Ensuring the water seal chamber is filled to the prescribed level is essential for the chest tube's effective functioning. This maintains the integrity of the system, prevents air from entering the pleural space, and facilitates proper drainage. Stripping the drainage tubing, keeping the drainage system below the chest level, or clamping the chest tube during ambulation are not recommended practices and can lead to complications.

2. A client has a new diagnosis of gout, and the nurse is providing dietary management education. Which of the following statements should the nurse include in the teaching?

• A. You should increase your intake of purine-rich foods.
• B. You should decrease your intake of purine-rich foods.
• C. You should avoid foods that contain lactose.
• D. You should increase your intake of dairy products.

Correct answer: B

Rationale: The correct answer is to decrease intake of purine-rich foods to manage uric acid levels and symptoms of gout. Purine-rich foods can exacerbate gout symptoms by increasing uric acid production, leading to flare-ups. Therefore, reducing purine intake is essential in the dietary management of gout. Option A is incorrect because increasing purine-rich foods can worsen gout symptoms. Option C is irrelevant as lactose is not directly related to gout. Option D is incorrect as increasing dairy products is not a recommended dietary modification for managing gout.

3. A client with a new diagnosis of osteoporosis is being taught about dietary management. Which of the following statements should be included in the teaching?

• A. You should increase your intake of calcium-rich foods.
• B. You should decrease your intake of potassium-rich foods.
• C. You should avoid foods that contain vitamin D.
• D. You should increase your intake of high-sodium foods.

Correct answer: A

Rationale: The correct answer is A: 'You should increase your intake of calcium-rich foods.' Increasing intake of calcium-rich foods is essential for managing osteoporosis because calcium is necessary for bone health and density. Adequate calcium intake can help prevent further bone loss and reduce the risk of fractures in individuals with osteoporosis. Choices B, C, and D are incorrect. Decreasing intake of potassium-rich foods is not necessary for osteoporosis management. Avoiding foods that contain vitamin D is counterproductive since vitamin D is essential for calcium absorption. Increasing intake of high-sodium foods is not recommended as it can contribute to bone loss and negatively impact bone health.

4. A client has a new prescription for furosemide. Which of the following instructions should the nurse include during discharge teaching?

• A. Avoid foods high in potassium.
• B. Monitor weight daily.
• C. Take the medication with food.
• D. Increase salt intake.

Correct answer: B

Rationale: Monitoring weight daily is crucial when taking furosemide to detect fluid retention or loss. Furosemide is a diuretic that helps the body get rid of excess water and salt through urine. Changes in weight can indicate fluid shifts, which could be a sign of inadequate response to the medication or worsening condition. Therefore, monitoring weight daily is essential to assess the effectiveness of furosemide therapy and detect any potential issues early on. Choices A, C, and D are incorrect. Avoiding foods high in potassium is more relevant for clients taking potassium-sparing diuretics, not furosemide. Taking furosemide with food is not necessary, as it can be taken with or without food. Increasing salt intake is contradictory to the purpose of furosemide, which aims to eliminate excess salt from the body.

5. When admitting a client at risk for falls in a long-term care facility, what should the nurse do first?

• A. Complete a fall-risk assessment
• B. Place a fall-risk identification bracelet on the client
• C. Provide the client with nonskid footwear
• D. Set the bed to the lowest position

Correct answer: A

Rationale: The initial step in caring for a client at risk for falls is to conduct a fall-risk assessment. This assessment helps the nurse gather crucial data to identify specific risks and individualized needs, guiding subsequent interventions and preventive measures. By completing a thorough assessment, the nurse can develop a targeted plan of care to mitigate fall risk and ensure the client's safety. Placing a fall-risk identification bracelet, providing nonskid footwear, or setting the bed to the lowest position may be important interventions, but these actions should be based on the findings of the fall-risk assessment, making choice A the priority.

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