Nursing Elites

1. A nurse is providing discharge teaching to a client who has a new diagnosis of heart failure. Which of the following client statements indicates an understanding of the teaching?

• A. I should weigh myself every morning.
• B. I should drink 2 liters of water each day.
• C. I should avoid all physical activity.
• D. I should take an extra dose of diuretic if I gain 2 pounds in a day.

Correct answer: A

Rationale: The corrected answer is A. Weighing daily is crucial for clients with heart failure to monitor fluid status since sudden weight gain can indicate fluid retention. Choice B is incorrect because excessive water intake can worsen fluid retention in heart failure. Choice C is incorrect as some physical activity is encouraged for heart failure clients, tailored to their condition. Choice D is incorrect as adjusting medication doses should always be done under healthcare provider guidance rather than self-administration.

2. Which lab value should be monitored in patients receiving heparin therapy?

• A. Monitor aPTT
• B. Monitor INR
• C. Monitor platelet count
• D. Monitor sodium levels

Correct answer: A

Rationale: The correct answer is to monitor aPTT in patients receiving heparin therapy. Activated Partial Thromboplastin Time (aPTT) is crucial to assess the therapeutic effectiveness of heparin and to prevent bleeding complications. Monitoring INR (Choice B) is more relevant for patients on warfarin therapy, not heparin. Platelet count (Choice C) monitoring is essential for detecting heparin-induced thrombocytopenia rather than assessing heparin therapy itself. Monitoring sodium levels (Choice D) is not directly related to heparin therapy monitoring.

3. A client with a new diagnosis of hypertension is receiving discharge teaching. Which statement by the client indicates an understanding of the teaching?

• A. I will take my medication only when I feel dizzy.
• B. I will check my blood pressure at least once a week.
• C. I will limit my saturated fat intake to 7% of daily calories.
• D. I will take my medication only when I have symptoms.

Correct answer: C

Rationale: The correct answer is C because limiting saturated fat intake to 7% of daily calories is a crucial component of the dietary management for hypertension. This dietary modification helps reduce the risk of cardiovascular complications. Choices A, B, and D are incorrect. Choice A is incorrect because medication adherence should not be based on symptoms like dizziness. Choice B is inadequate as blood pressure monitoring should be more frequent, preferably daily, for effective management of hypertension. Choice D is incorrect because medication for hypertension should be taken consistently as prescribed, not just when symptoms occur.

4. A client is experiencing an acute exacerbation of Crohn's disease. Which of the following actions should the nurse take?

• A. Encourage the client to increase dietary fiber.
• B. Maintain the client on a low-residue diet.
• C. Provide the client with frequent high-calorie snacks.
• D. Encourage the client to eat a high-fiber diet.

Correct answer: B

Rationale: During an acute exacerbation of Crohn's disease, the nurse should maintain the client on a low-residue diet. This diet helps to minimize bowel irritation by reducing the volume and frequency of stools. Choices A, C, and D are incorrect. Encouraging the client to increase dietary fiber (Choice A) and eat a high-fiber diet (Choice D) can worsen symptoms and aggravate bowel inflammation in Crohn's disease. Providing the client with frequent high-calorie snacks (Choice C) may not be appropriate during an exacerbation since high-fat foods can be harder to digest and may exacerbate symptoms.

5. Which laboratory test is essential for monitoring renal function in a patient with chronic kidney disease?

• A. Monitor BUN and creatinine levels
• B. Check blood glucose levels
• C. Monitor hemoglobin and hematocrit levels
• D. Monitor liver enzymes

Correct answer: A

Rationale: The correct answer is to monitor BUN (Blood Urea Nitrogen) and creatinine levels in a patient with chronic kidney disease. These tests provide crucial information about renal function. Checking blood glucose levels (Choice B) is important for monitoring diabetes, not renal function. Monitoring hemoglobin and hematocrit levels (Choice C) helps assess anemia, not specifically renal function. Monitoring liver enzymes (Choice D) is relevant for assessing liver function, not renal function.

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