Nursing Elites

1. A nurse is caring for a client who has chronic kidney disease and reports nausea. The nurse should identify that this client is at risk for which of the following imbalances?

• A. Metabolic alkalosis
• B. Metabolic acidosis
• C. Respiratory alkalosis
• D. Respiratory acidosis

Correct answer: B

Rationale: The correct answer is B: Metabolic acidosis. Clients with chronic kidney disease are at risk for metabolic acidosis because the kidneys are unable to effectively excrete acids, leading to an accumulation of acid in the body. This metabolic imbalance can result in symptoms like nausea. Choices A, C, and D are incorrect. Metabolic alkalosis is not typically associated with chronic kidney disease. Respiratory alkalosis is more commonly seen in conditions such as hyperventilation. Respiratory acidosis, on the other hand, is often linked to conditions affecting the lungs or respiratory system, not primarily kidney disease.

2. A client has a new prescription for metformin. Which of the following client statements indicates an understanding of the teaching?

• A. ''I will take this medication at bedtime to avoid nausea.''
• B. ''I should take this medication with a full glass of water in the morning.''
• C. ''I should avoid eating foods that contain iodine.''
• D. ''I should take this medication with food to improve absorption.''

Correct answer: B

Rationale: The correct answer is B. Metformin should be taken with a full glass of water in the morning to improve absorption and prevent gastrointestinal upset. Choice A is incorrect because metformin is not typically taken at bedtime. Choice C is unrelated to metformin therapy. Choice D is incorrect because metformin is actually better absorbed when taken with or after meals.

3. A nurse is providing dietary teaching to a client who has a new diagnosis of irritable bowel syndrome. Which of the following recommendations should the nurse include?

• A. Consume food high in bran fiber.
• B. Increase intake of milk products.
• C. Sweeten foods with fructose corn syrup.
• D. Increase foods high in gluten.

Correct answer: A

Rationale: The correct recommendation for a client with irritable bowel syndrome is to consume food high in bran fiber. Bran fiber promotes regularity and can help reduce symptoms of IBS. Choices B, C, and D are incorrect because increasing milk products, sweetening foods with fructose corn syrup, and consuming foods high in gluten can exacerbate symptoms of irritable bowel syndrome in some individuals.

4. A client with a new prescription for furosemide should increase intake of which of the following?

• A. You should take this medication on an empty stomach.
• B. You should increase your intake of potassium-rich foods.
• C. You should take this medication at bedtime.
• D. You should avoid taking this medication with food.

Correct answer: B

Rationale: The correct answer is B: 'You should increase your intake of potassium-rich foods.' Furosemide is a potassium-wasting diuretic, which means it can lead to low potassium levels in the body. Increasing intake of potassium-rich foods helps counteract this effect. Choices A, C, and D are incorrect because furosemide should not necessarily be taken on an empty stomach, at bedtime, or specifically avoided with food.

5. A client with a new diagnosis of peptic ulcer disease is receiving teaching from a nurse. Which of the following statements by the client indicates an understanding of the teaching?

• A. I will avoid taking ibuprofen for my pain.
• B. I will avoid eating spicy foods.
• C. I will limit my intake of dairy products.
• D. I will take my antacids 30 minutes before meals.

Correct answer: B

Rationale: The correct answer is B. Clients with peptic ulcer disease should avoid spicy foods as they can exacerbate symptoms and delay healing. Ibuprofen can worsen peptic ulcers by irritating the stomach lining, so it should be avoided. While limiting dairy products may be beneficial for some individuals with lactose intolerance, it is not a specific recommendation for peptic ulcer disease. Taking antacids before meals can help neutralize stomach acid; however, the timing may vary depending on the type of antacid, so there is no universal rule of taking antacids 30 minutes before meals. Choice A is incorrect because the client should avoid taking ibuprofen due to its potential to worsen peptic ulcers. Choice C is incorrect as there is no direct correlation between dairy product intake and peptic ulcer disease. Choice D is incorrect because the timing of antacid administration can vary and should be guided by specific recommendations.

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