Nursing Elites

1. A nurse is providing dietary teaching to a client who has chronic kidney disease. Which of the following food choices by the client indicates an understanding of the teaching?

• A. Peanut butter and jelly sandwich
• B. Grilled chicken and rice
• C. Tomato soup with saltine crackers
• D. Baked fish and steamed vegetables

Correct answer: D

Rationale: The correct answer is D, baked fish and steamed vegetables. These food choices are low in potassium and phosphorus, which is important for clients with chronic kidney disease to manage their condition effectively. Grilled chicken and rice (choice B) may be high in phosphorus, tomato soup with saltine crackers (choice C) is high in sodium, and a peanut butter and jelly sandwich (choice A) contains high levels of potassium, all of which are not ideal choices for individuals with chronic kidney disease.

2. A nurse is caring for a client who has a pulmonary embolism. The nurse should identify the effectiveness of the treatment by assessing which of the following?

• A. A chest x-ray reveals increased density in all lung fields
• B. The client reports feeling less anxious
• C. Diminished breath sounds are auscultated unilaterally
• D. ABG results include pH 7.48, PaO2 77 mm Hg, and PaCO2 47 mm Hg

Correct answer: B

Rationale: The correct answer is B. Client-reported improvement in anxiety is an indication of effective treatment for pulmonary embolism. Choice A is incorrect as increased density in all lung fields on a chest x-ray may indicate complications or lack of improvement. Choice C is incorrect as diminished breath sounds auscultated unilaterally may suggest a localized lung issue and not necessarily reflect the effectiveness of treatment for a pulmonary embolism. Choice D is incorrect as the ABG results provided do not specifically indicate the effectiveness of treatment for a pulmonary embolism.

3. A client with osteoporosis needs to increase calcium intake. Which of the following foods should be recommended by the nurse?

• A. Carrots
• B. Broccoli
• C. Chicken
• D. Bananas

Correct answer: B

Rationale: The correct answer is B: Broccoli. Broccoli is rich in calcium and is a suitable food to recommend to clients with osteoporosis to increase their calcium intake. Carrots, chicken, and bananas are not as high in calcium content compared to broccoli and therefore not the most appropriate choices for increasing calcium intake in clients with osteoporosis.

4. A nurse is performing a gastric lavage for a client who has upper gastrointestinal bleeding. Which of the following actions should the nurse take?

• A. Instill 500 ml of solution through the NG tube
• B. Insert a large-bore NG tube
• C. Use a cold irrigation solution
• D. Instruct the client to lie on his right side

Correct answer: B

Rationale: The correct answer is B: 'Insert a large-bore NG tube.' When performing a gastric lavage for a client with upper gastrointestinal bleeding, a large-bore NG tube is used to effectively remove gastric contents and blood. Option A is incorrect because the amount of solution to instill depends on the specific situation and should be guided by the healthcare provider's order. Option C is incorrect because using a cold irrigation solution can lead to hypothermia and is not recommended. Option D is incorrect as there is no need to instruct the client to lie on his right side specifically for gastric lavage.

5. A nurse is discussing group treatment and therapy with a client. The nurse should include which of the following as being a characteristic of a therapeutic group?

• A. The group is organized in an autocratic structure
• B. The group encourages members to focus on a particular issue
• C. The group must be led by a licensed psychiatrist
• D. The group encourages clients to form dependent relationships

Correct answer: B

Rationale: The correct answer is B. Therapeutic groups indeed encourage members to focus on particular issues. This focus helps individuals address specific concerns, work through challenges, and support one another in a structured setting. Choice A is incorrect because therapeutic groups typically promote a democratic structure that values input from all members rather than an autocratic one. Choice C is incorrect as therapeutic groups can be led by various mental health professionals, not solely by licensed psychiatrists. Choice D is incorrect; therapeutic groups aim to foster independent growth and self-reliance rather than promoting dependent relationships.

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