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 administering a blood transfusion to a client and suspects that the client is having an adverse reaction to the blood. Which of the following actions should the nurse take first?

• A. Maintain IV access
• B. Obtain the client’s vital signs
• C. Contact the provider
• D. Stop the transfusion

Correct answer: D

Rationale: The correct answer is to stop the transfusion. When a nurse suspects an adverse reaction to a blood transfusion, the priority is to stop the infusion immediately to prevent further harm to the client. Maintaining IV access and obtaining vital signs can be important steps but should come after stopping the transfusion to ensure the client's safety. Contacting the provider is necessary but not the first action to take in this situation. Therefore, the nurse should prioritize stopping the transfusion to address the potential adverse reaction.

3. A client is being educated about using an intrauterine device (IUD) for contraception. Which of the following client statements indicate an understanding of the teaching?

• A. I will need to have the IUD replaced each year.
• B. I will need to apply a spermicide prior to intercourse.
• C. I should expect my periods to stop while I have the IUD.
• D. I should check for the string each month after menstruation.

Correct answer: D

Rationale: The correct answer is D because the client should check for the string each month after menstruation to ensure the IUD is in place. This practice helps in identifying any displacement of the IUD. Choices A, B, and C are incorrect. A is incorrect because IUDs have different durations depending on the type, not all require yearly replacement. B is incorrect because IUDs do not require spermicide for effectiveness. C is incorrect because while some individuals may experience changes in their menstrual patterns, it is not guaranteed that periods will stop while using an IUD.

4. A nurse is reviewing the medical records of a group of older adult clients. The nurse should identify which of the following as a risk factor for developing infections?

• A. Increased physical activity
• B. Lowered immune system function
• C. Regular health screenings
• D. Proper nutrition

Correct answer: B

Rationale: The correct answer is B: Lowered immune system function. In older adults, a decline in immune system function increases the risk of developing infections. Increased physical activity (choice A) and proper nutrition (choice D) generally support immune function and overall health, reducing the risk of infections. Regular health screenings (choice C) are important for early detection of health issues but do not directly increase the risk of infections.

5. A nurse is educating a client about caloric intake and weight reduction. Which of the following client statements indicates an understanding of the teaching?

• A. If I eat 500 fewer calories per day, I should lose 1 pound per week.
• B. If I eat 450 fewer calories per day, I should lose 2 pounds per week.
• C. If I eat 250 fewer calories per day, I should lose 2 pounds per week.
• D. If I eat 300 fewer calories per day, I should lose 1 pound per week.

Correct answer: A

Rationale: The correct answer is A: 'If I eat 500 fewer calories per day, I should lose 1 pound per week.' This statement is accurate because a reduction of 500 calories per day typically results in a weight loss of 1 pound per week. This is based on the principle that a calorie deficit of 3,500 calories equals about 1 pound of body fat. Choices B, C, and D are incorrect because they do not align with the established relationship between calorie reduction and weight loss. Eating 450 fewer calories per day would not lead to a weight loss of 2 pounds per week; similarly, reducing calories by 250 or 300 per day would not result in losing 2 pounds or 1 pound per week, respectively.

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