Nursing Elites

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

• A. I will decrease my intake of foods that are high in phosphorus
• B. I will increase my intake of foods that are high in potassium
• C. I will decrease my intake of foods that are high in iron
• D. I will increase my intake of calcium supplements

Correct answer: A

Rationale: The correct answer is A. Clients with chronic kidney disease should limit their intake of phosphorus because high phosphorus levels can lead to bone disease and cardiovascular problems. Increasing foods high in potassium (choice B) is not recommended as it can be harmful to individuals with kidney disease. Decreasing intake of foods high in iron (choice C) is not specifically indicated for chronic kidney disease. Increasing calcium supplements (choice D) may not be necessary and can potentially lead to hypercalcemia in individuals with kidney disease.

2. A nurse providing dietary teaching for a client who is at 29 weeks of gestation and has phenylketonuria. Which of the following suggested foods should the nurse include in the teaching?

• A. A peanut butter sandwich on wheat bread
• B. A sliced apple and red grapes
• C. A chocolate chip cookie with a glass of skim milk
• D. A scrambled egg with cheddar cheese

Correct answer: B

Rationale: The correct answer is B. Clients with phenylketonuria (PKU) must adhere to a strict low-phenylalanine diet to prevent neurological damage. Foods high in phenylalanine such as peanut butter, wheat bread, chocolate chip cookies, milk, scrambled eggs, and cheddar cheese should be avoided. Sliced apples and red grapes are low in phenylalanine, making them safe choices for individuals with PKU. Choice A (peanut butter sandwich on wheat bread), Choice C (chocolate chip cookie with a glass of skim milk), and Choice D (scrambled egg with cheddar cheese) are all high in phenylalanine and should be avoided by individuals with PKU.

3. A nurse is admitting a client who has suspected appendicitis. Which of the following findings should the nurse report to the provider immediately?

• A. Distended, board-like abdomen
• B. WBC count of 15,000/mm³
• C. Rebound tenderness over McBurney’s point
• D. Temperature of 37.3°C (99.1°F)

Correct answer: A

Rationale: A distended, board-like abdomen is a concerning sign indicating the possibility of a ruptured appendix and peritonitis, which are medical emergencies. Reporting this finding immediately is crucial for prompt intervention. Choice B, an elevated WBC count, could indicate infection but is not as urgent as the risk of a ruptured appendix. Choice C, rebound tenderness over McBurney’s point, is a classic sign of appendicitis but does not indicate an immediate threat like a possible rupture. Choice D, a slightly elevated temperature, is a nonspecific finding and not as critical as the risk of peritonitis associated with a distended, board-like abdomen.

4. A healthcare provider is caring for a client prescribed amiodarone. Which of the following should the healthcare provider monitor?

• A. Liver function tests
• B. Serum potassium levels
• C. Blood pressure
• D. All of the above

Correct answer: D

Rationale: Amiodarone is known to potentially affect liver function, potassium levels, and blood pressure. Monitoring all these parameters regularly is crucial to detect any adverse effects early on. Liver function tests are necessary as amiodarone can cause hepatotoxicity. Serum potassium levels should be monitored due to the risk of hypokalemia or hyperkalemia with amiodarone use. Blood pressure monitoring is essential as amiodarone can cause hypotension or hypertension. Choosing 'All of the above' is the correct answer because all these parameters should be monitored to ensure the client's safety and well-being. Monitoring only one or two of these parameters may lead to missing important signs of adverse effects.

5. A client is found on the floor of their room experiencing a seizure. Which of the following actions is the priority for the nurse?

• A. Place the client on their side with their head forward
• B. Call for help
• C. Protect the client's head
• D. Restrain the client

Correct answer: A

Rationale: During a seizure, the priority action for the nurse is to place the client on their side with their head forward. This position helps maintain an open airway and prevents aspiration, which is crucial in managing the client's safety during a seizure. Calling for help is important but ensuring the client's immediate safety by positioning them correctly takes precedence. Protecting the client's head can be done concurrently while positioning the client. Restraint is not appropriate during a seizure as it can lead to injuries and complications.

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