Nursing Elites

1. A nurse is planning care for a client who has chronic renal failure. Which action should the nurse include in the plan of care?

• A. Encourage increased fluid intake
• B. Restrict protein intake to the RDA
• C. Increase dietary potassium
• D. Encourage foods high in sodium

Correct answer: B

Rationale: The correct action the nurse should include in the plan of care for a client with chronic renal failure is to restrict protein intake to the RDA. This is important because limiting protein helps reduce the buildup of waste products that the kidneys are unable to efficiently excrete. Encouraging increased fluid intake (choice A) may further burden the kidneys, increasing the risk of fluid overload. Increasing dietary potassium (choice C) is not recommended in chronic renal failure as impaired kidneys have difficulty regulating potassium levels. Encouraging foods high in sodium (choice D) is also not appropriate as excessive sodium intake can lead to fluid retention and hypertension, which are detrimental in renal failure.

2. A nurse is caring for a client with a new prescription for clindamycin. Which of the following should the nurse monitor?

• A. Liver function
• B. Serum potassium
• C. Signs of superinfection
• D. Blood glucose

Correct answer: C

Rationale: The correct answer is C: Signs of superinfection. Clindamycin can lead to antibiotic-associated colitis and other superinfections, making it crucial for the nurse to monitor the client for signs of superinfection. Monitoring liver function (choice A) is not typically associated with clindamycin use. Serum potassium levels (choice B) and blood glucose (choice D) are also not directly affected by clindamycin, so they are not the priority for monitoring in this case.

3. A client has been diagnosed with tuberculosis. Which of the following precautions should the nurse initiate to prevent transmission of the disease?

• A. Contact precautions
• B. Airborne precautions
• C. Droplet precautions
• D. Protective environment

Correct answer: B

Rationale: Tuberculosis is spread through small droplets, measuring less than 5 microns, which can remain airborne for extended periods. The nurse should place a client with TB under airborne precautions to prevent the transmission of the disease. Choice A, contact precautions, are used for diseases that spread by direct or indirect contact. Choice C, droplet precautions, are for diseases transmitted by large droplets. Choice D, protective environment, is used for clients who have compromised immune systems.

4. To reduce the incidence of sudden infant death syndrome (SIDS), how should the parents position the newborn?

• A. Prone position
• B. Supine position
• C. Side-lying position
• D. Semi-Fowler's position

Correct answer: B

Rationale: The correct answer is B: Supine position. Placing the newborn on their back (supine position) is the safest sleeping position to reduce the risk of sudden infant death syndrome (SIDS). This position helps prevent airway obstruction, which can occur when infants are placed on their stomach (prone position), side (side-lying position), or in a semi-upright position (semi-Fowler's position). The prone position (choice A) is associated with an increased risk of SIDS, making it an unsafe choice. Side-lying position (choice C) and semi-Fowler's position (choice D) also pose risks of airway compromise and are not recommended for sleep positioning to prevent SIDS. Therefore, options A, C, and D are incorrect in this context.

5. A healthcare provider is educating a patient on the use of alendronate. Which of the following should be included?

• A. Take it with food
• B. Take it once a week
• C. It can be taken at bedtime
• D. Monitor for increased appetite

Correct answer: B

Rationale: The correct answer is B: 'Take it once a week.' Alendronate is typically taken once a week to treat osteoporosis. It should be taken on an empty stomach in the morning with a full glass of water. Choice A is incorrect because alendronate should be taken on an empty stomach, not with food. Choice C is incorrect because alendronate should be taken in the morning, not at bedtime. Choice D is unrelated to alendronate use and not a common side effect associated with this medication.

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