Nursing Elites

1. A nurse is providing dietary teaching for a client who has chronic cholecystitis. Which of the following diets should the nurse recommend?

• A. Low potassium diet
• B. High fiber diet
• C. Low fat diet
• D. Low sodium diet

Correct answer: C

Rationale: The correct answer is C: Low fat diet. A low-fat diet is recommended for clients with chronic cholecystitis to reduce episodes of biliary colic. High-fat foods can trigger symptoms by causing the gallbladder to contract, leading to pain. Choice A, a low potassium diet, is not specifically indicated for chronic cholecystitis. Choice B, a high fiber diet, though generally healthy, may worsen symptoms in some individuals with cholecystitis due to the increased intestinal gas production. Choice D, a low sodium diet, is not directly related to the management of chronic cholecystitis.

2. What medication should be given first to a patient experiencing wheezing and coughing due to an allergic reaction?

• A. Albuterol 3 ml via nebulizer
• B. Cromolyn via nebulizer
• C. Aminophylline IV
• D. Methylprednisolone 100 mg IV

Correct answer: A

Rationale: The correct answer is Albuterol 3 ml via nebulizer. Albuterol is a bronchodilator that helps relieve wheezing and coughing by opening up the airways, making it the first-line treatment for allergic reactions presenting with these symptoms. Cromolyn and aminophylline are not typically used as first-line treatments for acute allergic reactions with wheezing and coughing. Methylprednisolone, a corticosteroid, may be beneficial for inflammation in the setting of an allergic reaction but is not the initial medication of choice to address wheezing and coughing.

3. What should the nurse do when a patient experiences abdominal cramping during enema administration?

• A. Lower the height of the enema solution container
• B. Stop the procedure and remove the tubing
• C. Continue the enema at a slower rate
• D. Increase the flow of the enema solution

Correct answer: A

Rationale: When a patient experiences abdominal cramping during enema administration, the nurse should lower the height of the enema solution container. Lowering the height helps relieve cramping by slowing down the flow of the enema, reducing discomfort for the patient. Choice B, stopping the procedure and removing the tubing, is incorrect as it does not directly address the cramping issue. Choice C, continuing the enema at a slower rate, could potentially worsen the cramping by prolonging the discomfort. Choice D, increasing the flow of the enema solution, is also incorrect as it may intensify the cramping and cause more discomfort to the patient.

4. What lab value should be prioritized for monitoring in a patient with HIV?

• A. CD4 T-cell count below 180 cells/mm3
• B. Hemoglobin levels
• C. Serum albumin levels
• D. White blood cell count

Correct answer: A

Rationale: The correct answer is A: CD4 T-cell count below 180 cells/mm3. Monitoring CD4 T-cell count is crucial in patients with HIV as it reflects the status of their immune system. A CD4 count below 200 cells/mm3 is indicative of severe immunocompromise, necessitating close monitoring and potential intervention. Choices B, C, and D are less specific to HIV management and do not directly reflect the immune status in these patients. Hemoglobin levels are more relevant for assessing anemia, serum albumin levels for nutritional status, and white blood cell count for overall immune response, but none are as directly tied to HIV disease progression as the CD4 T-cell count.

5. A client has a Transient Ischemic Attack (TIA). What should the nurse teach?

• A. Avoid eating within 3 hours of bedtime
• B. Consume liquids between meals
• C. Eat large meals to increase caloric intake
• D. Avoid liquids to prevent aspiration

Correct answer: A

Rationale: The correct answer is A: Avoid eating within 3 hours of bedtime. For a client with a Transient Ischemic Attack (TIA), it is crucial to avoid eating within 3 hours of bedtime to reduce reflux that can worsen symptoms. Choice B is incorrect because consuming liquids between meals is not specifically related to managing TIA. Choice C is incorrect as eating large meals may not be recommended, especially if the client needs to watch their caloric intake. Choice D is incorrect because avoiding liquids entirely can lead to dehydration and is not a standard recommendation for TIA management.

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