Nursing Elites

1. A client has acute dysphagia. Which of the following nursing interventions should be included in the plan of care?

• A. Providing a straw for consumption of liquids
• B. Encouraging larger bites
• C. Placing the client in semi-Fowler's position during meals
• D. Instructing the client to tilt head forward when swallowing

Correct answer: C

Rationale: Placing the client in semi-Fowler's position during meals is the correct intervention for a client with acute dysphagia. This position helps prevent aspiration by facilitating swallowing. Providing a straw for consumption of liquids (Choice A) can increase the risk of aspiration and is not recommended for clients with dysphagia. Encouraging larger bites (Choice B) can also increase the risk of choking and aspiration. Instructing the client to tilt the head forward when swallowing (Choice D) is not the recommended technique for managing dysphagia as it does not address the underlying issue effectively.

2. A client with pre-dialysis end-stage kidney disease is being taught about diet. Which of the following instructions should the nurse include?

• A. Increase intake of dietary phosphorus.
• B. Eliminate foods high in protein from your diet.
• C. Reduce intake of foods high in potassium.
• D. Increase intake of sodium-containing foods.

Correct answer: C

Rationale: In pre-dialysis end-stage kidney disease, reducing intake of foods high in potassium is crucial as impaired kidney function can lead to potassium buildup in the blood, which can be dangerous. High potassium levels can cause irregular heartbeats and even cardiac arrest. Therefore, advising the client to reduce potassium-rich foods is essential to prevent complications. Choices A, B, and D are incorrect. Increasing dietary phosphorus, eliminating foods high in protein, or increasing sodium-containing foods are not appropriate recommendations for a client with pre-dialysis end-stage kidney disease as they can exacerbate the condition.

3. Which of the following suggestions is the healthiest for Miguel, who is always hungry and never seems to feel full despite eating enough calories?

• A. Switch out energy-dense foods with more nutrient-dense foods that are more likely to make him feel full
• B. Drink adequate amounts of water
• C. A, B
• D. Eat foods with more fat, as fat slows gastric emptying and will make him feel more full

Correct answer: C

Rationale: The correct answer is A and B. Switching to more nutrient-dense foods can help Miguel feel full despite eating enough calories. Nutrient-dense foods provide essential nutrients and are more satisfying. Drinking adequate water is also crucial for overall health and can help with feelings of fullness. Choice D is incorrect because while fat can contribute to satiety, it should be consumed in balance with other nutrients. Consuming foods with high fat content excessively may lead to other health issues and does not address the underlying problem of feeling constantly hungry despite eating.

4. A nurse is reviewing the laboratory results for a client who has a history of atherosclerosis and notes elevated cholesterol levels. Which of the following statements by the client indicates the nurse should plan follow-up teaching on a low-cholesterol diet?

• A. "I flavor my meat with lemon juice."?
• B. "I eat two eggs for breakfast each morning."?
• C. "I cook my food with canola oil."?
• D. "I take an omega-3 supplement daily."?

Correct answer: B

Rationale: The correct answer is B. Eggs are high in cholesterol, so someone with elevated cholesterol levels, especially with a history of atherosclerosis, should be cautious about egg consumption. Choices A, C, and D are not as concerning for cholesterol levels. Lemon juice, canola oil, and omega-3 supplements do not significantly impact cholesterol levels compared to consuming eggs regularly.

5. A fire has broken in the unit of DMLM R.N. The best leadership style suited in cases of emergencies like this is:

• A. Autocratic
• B. Participative
• C. Democratic
• D. Laissez Faire

Correct answer: D

Rationale: Understanding the underlying pathology and therapeutic techniques ensures that nursing care is not only reactive but also preventative, reducing the risk of complications.

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