Nursing Elites

1. A nurse is caring for a client who has a new diagnosis of hypercholesterolemia. Which of the following dietary recommendations should the nurse make?

• A. Increase intake of red meat
• B. Consume foods high in saturated fats
• C. Choose foods low in trans fats
• D. Limit intake of vegetables and fruits

Correct answer: C

Rationale: The correct answer is C: 'Choose foods low in trans fats.' Trans fats are known to increase cholesterol levels, so avoiding foods high in trans fats is essential in managing hypercholesterolemia. Option A, increasing intake of red meat, and option B, consuming foods high in saturated fats, can worsen cholesterol levels as they are sources of unhealthy fats. Option D, limiting intake of vegetables and fruits, is incorrect as they are part of a heart-healthy diet and should be encouraged for individuals with hypercholesterolemia.

2. A nurse is caring for a client who is scheduled for a colonoscopy. Which of the following findings should the nurse report to the provider?

• A. Client reports taking ibuprofen daily
• B. Client has a history of asthma
• C. Client reports drinking one glass of wine daily
• D. Client has a history of diverticulitis

Correct answer: A

Rationale: The correct answer is A. Ibuprofen is an NSAID that can increase the risk of bleeding during a colonoscopy due to its effects on platelet function. It is important to report this finding to the provider to consider alternative pain management options. Choices B, C, and D are not the most pertinent to report for a colonoscopy. Asthma and a history of diverticulitis are relevant medical history but do not directly impact the colonoscopy procedure. Drinking one glass of wine daily is not a concern specifically related to the colonoscopy procedure.

3. A nurse is assessing a client who is receiving enteral nutrition via a nasogastric tube. Which of the following findings should the nurse report to the provider?

• A. Gastric pH of 2.5.
• B. Bowel sounds every 4 hours.
• C. Diarrhea of 250 mL in 24 hours.
• D. Gastric residual of 150 mL.

Correct answer: D

Rationale: A gastric residual of 150 mL may indicate delayed gastric emptying and should be reported to the provider.

4. A nurse is caring for a client who is comatose and has advance directives that indicate the client does not want life-sustaining measures. The client's family wants the client to have life-sustaining measures. Which of the following actions should the nurse take?

• A. Arrange for an ethics committee meeting to address the family's concerns
• B. Support the family's decision and initiate life-sustaining measures
• C. Complete an incident report
• D. Encourage the family to contact an attorney

Correct answer: A

Rationale: In this scenario, the nurse should arrange for an ethics committee meeting to address the family's concerns while ensuring the client's wishes are respected. Choosing option A allows for a formal discussion involving healthcare professionals, family members, and possibly a legal expert to navigate the situation ethically and legally. Supporting the family's decision to initiate life-sustaining measures (option B) would disregard the client's advance directives and autonomy. Completing an incident report (option C) is not appropriate in this situation as it does not address the conflict of interest between the family's desires and the client's wishes. Encouraging the family to contact an attorney (option D) may escalate the situation unnecessarily before exploring more ethical and collaborative approaches.

5. A nurse is providing dietary teaching to a client with chronic kidney disease. Which of the following foods should the nurse recommend?

• A. Canned soup
• B. Bananas
• C. White bread
• D. Processed meats

Correct answer: C

Rationale: The correct answer is C: White bread. White bread is low in potassium, making it a suitable choice for clients with chronic kidney disease to prevent hyperkalemia. Canned soup (choice A), bananas (choice B), and processed meats (choice D) are high in potassium and should be limited or avoided by individuals with chronic kidney disease to manage their condition effectively.

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