Nursing Elites

1. When a client reports being allergic to penicillin, which question should the nurse ask to gather more information?

• A. Are you allergic to any other medications?
• B. How often have you taken penicillin in the past?
• C. Is anyone else in your family allergic to penicillin?
• D. What happens to you when you take penicillin?

Correct answer: D

Rationale: Questioning the client about the specific allergic reaction to penicillin is crucial for assessing the severity and type of allergic response, aiding in determining appropriate treatment and avoiding potential adverse reactions.

2. A client with liver cirrhosis is being educated about managing their condition. Which statement by the client indicates a need for further teaching?

• A. I will avoid drinking alcohol
• B. I need to limit my salt intake
• C. I can take acetaminophen for pain
• D. I should eat a balanced diet

Correct answer: C

Rationale: The correct answer is C. Clients with liver cirrhosis should avoid acetaminophen because it can cause further liver damage. Acetaminophen is metabolized in the liver, and in individuals with liver disease, it can lead to liver toxicity. Therefore, clients with liver cirrhosis should use alternative pain medications that do not affect the liver, such as nonsteroidal anti-inflammatory drugs (NSAIDs) or opioids as prescribed by their healthcare provider. Choices A, B, and D are correct statements for managing liver cirrhosis. Avoiding alcohol helps prevent further liver damage, limiting salt intake helps manage fluid retention and complications like ascites, and eating a balanced diet supports overall health and helps prevent malnutrition.

3. After a client's neck dissection surgery resulted in damage to the superior laryngeal nerve, what area of assessment should the nurse prioritize?

• A. The client's swallowing ability
• B. The client's ability to speak
• C. The client's management of secretions
• D. The client's airway patency

Correct answer: A

Rationale: Damage to the superior laryngeal nerve can lead to swallowing difficulties due to impaired laryngeal function. As a result, assessing the client's swallowing ability is crucial to prevent aspiration and ensure proper nutrition and hydration.

4. A patient with Parkinson's disease is prescribed levodopa. What dietary modification should the nurse suggest to the patient?

• A. Increase intake of vitamin C.
• B. Limit foods high in protein.
• C. Avoid foods rich in fiber.
• D. Increase sodium intake.

Correct answer: B

Rationale: The correct answer is to limit foods high in protein. Patients taking levodopa should restrict their intake of protein-rich foods because protein can interfere with the absorption of the medication. Levodopa competes with dietary proteins for absorption in the small intestine, potentially reducing the effectiveness of the medication. Therefore, by reducing protein intake, the patient can enhance the absorption and therapeutic effects of levodopa. Increasing vitamin C intake is not necessary for patients prescribed with levodopa. Avoiding foods rich in fiber or increasing sodium intake are not directly related to optimizing levodopa therapy and might not benefit the patient's condition.

5. The nurse is administering sevelamer (RenaGel) during lunch to a client with end-stage renal disease (ESRD). The client asks the nurse to bring the medication later. The nurse should describe which action of RenaGel as an explanation for taking it with meals?

• A. Prevents indigestion associated with the ingestion of spicy foods.
• B. Binds with phosphorus in foods and prevents absorption.
• C. Promotes stomach emptying and prevents gastric reflux.
• D. Buffers hydrochloric acid and prevents gastric erosion.

Correct answer: B

Rationale: Sevelamer (RenaGel) binds with phosphorus in foods to prevent its absorption, which is why it should be taken with meals. By taking RenaGel with meals, it can effectively bind with phosphorus from food, reducing the amount of phosphorus absorbed by the body, thus helping to manage hyperphosphatemia in clients with ESRD. Choices A, C, and D are incorrect because RenaGel's primary action is to bind with phosphorus in foods, not related to preventing indigestion, promoting stomach emptying, or buffering hydrochloric acid.

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