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 providing teaching to a client about the adverse effects of sertraline. Which of the following adverse effects should the nurse include?

• A. Excessive sweating.
• B. Increased urinary frequency.
• C. Dry cough.
• D. Metallic taste in the mouth.

Correct answer: A

Rationale: The correct adverse effect of sertraline that the nurse should include in the teaching is excessive sweating. Sertraline is known to cause this side effect in some individuals. Increased urinary frequency (choice B) is not a commonly reported adverse effect of sertraline. Dry cough (choice C) and metallic taste in the mouth (choice D) are also not typically associated with sertraline use. Therefore, the nurse should focus on educating the client about the potential adverse effect of excessive sweating.

3. A client who is taking phenytoin is being taught about contraceptive options. Which of the following statements should the nurse make?

• A. You should use a backup method of birth control while taking phenytoin.
• B. Phenytoin can decrease the effectiveness of oral contraceptives.
• C. You should stop taking phenytoin while using oral contraceptives.
• D. Phenytoin can increase the effectiveness of oral contraceptives.

Correct answer: B

Rationale: The correct answer is B. Phenytoin can decrease the effectiveness of oral contraceptives, so it is important to inform the client about this interaction. Using an additional form of contraception, such as a backup method, is recommended to ensure adequate protection against pregnancy. Choice A is incorrect because it lacks specificity about the decrease in effectiveness of oral contraceptives caused by phenytoin. Choice C is incorrect as it suggests stopping phenytoin use while using oral contraceptives, which is not the appropriate action. Choice D is incorrect as phenytoin is known to decrease, not increase, the effectiveness of oral contraceptives.

4. A nurse is reviewing the laboratory values of a client who has liver cirrhosis. Which of the following findings should the nurse report to the provider?

• A. Bilirubin 0.8 mg/dL
• B. Ammonia 35 mcg/dL
• C. Prothrombin time 16 seconds
• D. Albumin 4 g/dL

Correct answer: C

Rationale: In clients with liver cirrhosis, an elevated prothrombin time indicates impaired liver function and decreased production of clotting factors. This finding should be reported to the provider for further evaluation and management. Choices A, B, and D are within normal ranges and do not specifically indicate worsening liver cirrhosis. Bilirubin 0.8 mg/dL is normal, ammonia 35 mcg/dL is within the reference range, and albumin 4 g/dL is also within the normal range for this client population.

5. A nurse is assessing a client who has left-sided heart failure. Which of the following should the nurse identify as a manifestation of pulmonary congestion?

• A. Frothy, pink sputum
• B. Jugular vein distention
• C. Weight gain
• D. Bradypnea

Correct answer: A

Rationale: Correct! Frothy, pink sputum is a classic sign of pulmonary congestion in left-sided heart failure. This occurs due to the accumulation of fluid in the lungs, leading to the coughing up of frothy, pink-tinged sputum. Jugular vein distention (choice B) is more indicative of right-sided heart failure, where fluid backs up into the systemic circulation. Weight gain (choice C) may occur due to fluid retention, but it is not a direct manifestation of pulmonary congestion. Bradypnea (choice D) refers to abnormally slow breathing and is not specifically associated with pulmonary congestion.

Similar Questions