Nursing Elites

1. A nurse is preparing to teach a client with chronic renal failure. Which dietary instruction is most appropriate?

• A. Increase calcium intake
• B. Increase potassium intake
• C. Increase protein intake
• D. Restrict protein intake

Correct answer: D

Rationale: The correct answer is to restrict protein intake for a client with chronic renal failure. In renal failure, the kidneys are unable to effectively filter waste products. Excessive protein intake can lead to the accumulation of waste products, increasing the workload on the kidneys. Therefore, restricting protein intake is essential to prevent further kidney damage. Choices A, B, and C are incorrect. Increasing calcium intake is not specifically indicated for chronic renal failure. Increasing potassium intake can be dangerous in renal failure as impaired kidneys may not be able to excrete excess potassium. Increasing protein intake is contraindicated in chronic renal failure as it can worsen kidney function and increase the accumulation of waste products.

2. When teaching a client about the use of risperidone, which of the following should be included?

• A. It is an SSRI
• B. Monitor for metabolic syndrome
• C. It has no side effects
• D. It can be taken with alcohol

Correct answer: B

Rationale: The correct answer is B: 'Monitor for metabolic syndrome.' Risperidone is not an SSRI but an atypical antipsychotic. Choice A is incorrect. Choice C is also incorrect as risperidone, like any medication, can have side effects. Choice D is wrong because alcohol consumption should generally be avoided while taking risperidone. Educating clients about monitoring for metabolic syndrome, weight gain, and other potential side effects is crucial in managing their health effectively while on this medication.

3. A nurse is preparing to administer a client's first dose of a new antibiotic. Which of the following is the priority nursing action?

• A. Assess the client's allergies.
• B. Monitor the client's vital signs.
• C. Inform the client of potential side effects.
• D. Obtain the client's informed consent.

Correct answer: A

Rationale: Assessing allergies before administering a new medication is crucial as it helps prevent potentially life-threatening allergic reactions like anaphylaxis. While monitoring vital signs and informing the client of side effects are important nursing actions, assessing allergies takes precedence to ensure the client's safety. Informed consent is necessary for the treatment process, but assessing allergies is the priority before administering any new medication.

4. A school nurse is providing care for students in an elementary education facility. What intervention by the nurse addresses the primary level of prevention?

• A. Monitor for signs of illness.
• B. Teach students about healthy food choices.
• C. Administer medication to students with chronic conditions.
• D. Monitor immunization compliance.

Correct answer: B

Rationale: The correct answer is B: Teach students about healthy food choices. Teaching healthy habits like proper nutrition is an example of primary prevention because it aims to prevent disease before it occurs. Choice A, monitoring for signs of illness, is more related to secondary prevention (early detection and treatment). Choice C, administering medication to students with chronic conditions, is a form of tertiary prevention (managing existing conditions to prevent complications). Choice D, monitoring immunization compliance, is also a form of primary prevention but focuses on preventing specific infectious diseases through immunization rather than general health promotion.

5. A client gave birth 4 hours ago and is experiencing excessive vaginal bleeding. Which of the following actions should the nurse plan to take first?

• A. Elevate the client's legs to a 30° angle
• B. Insert an indwelling urinary catheter
• C. Massage the client's fundus
• D. Initiate an infusion of oxytocin

Correct answer: C

Rationale: The correct answer is to massage the client's fundus first. Uterine atony is a common cause of postpartum hemorrhage, and massaging the fundus can help stimulate uterine contractions, which will assist in reducing bleeding. Elevating the client's legs to a 30° angle (Choice A) is not the priority in this situation as fundal massage takes precedence. Inserting an indwelling urinary catheter (Choice B) may be necessary but should not take precedence over managing the postpartum hemorrhage. Initiating an infusion of oxytocin (Choice D) is a valid intervention to address uterine atony, but massaging the fundus should come first to promote immediate contraction and control bleeding.

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