Nursing Elites

1. A client has a new diagnosis of nephrotic syndrome, and the nurse is providing dietary management education. Which of the following statements should the nurse include in the teaching?

• A. You should increase your intake of high-sodium foods.
• B. You should decrease your intake of high-sodium foods.
• C. You should avoid foods that contain lactose.
• D. You should increase your intake of dairy products.

Correct answer: B

Rationale: For a client with nephrotic syndrome, decreasing the intake of high-sodium foods is essential to manage fluid retention and symptoms of the condition. Excessive sodium can lead to fluid retention, swelling, and worsen the condition. Therefore, advising the client to decrease their high-sodium food intake aligns with the dietary management approach to help control nephrotic syndrome. Choices A, C, and D are incorrect. Increasing high-sodium foods would exacerbate fluid retention, avoiding lactose is not specifically required for nephrotic syndrome, and increasing dairy products may not be necessary unless individualized based on the client's needs and lab values.

2. What action should the healthcare provider take for a patient with a chest tube?

• A. Strip the drainage tubing every 4 hours.
• B. Keep the drainage system below the level of the patient's chest.
• C. Clamp the chest tube when ambulating the patient.
• D. Ensure the water seal chamber is filled to the prescribed level.

Correct answer: D

Rationale: Ensuring the water seal chamber is filled to the prescribed level is essential for the chest tube's effective functioning. This maintains the integrity of the system, prevents air from entering the pleural space, and facilitates proper drainage. Stripping the drainage tubing, keeping the drainage system below the chest level, or clamping the chest tube during ambulation are not recommended practices and can lead to complications.

3. A client with a new diagnosis of chronic kidney disease is being taught about dietary management. Which of the following statements should be included in the teaching?

• A. Increase your intake of protein-rich foods.
• B. Decrease your intake of phosphorus-rich foods.
• C. Avoid foods that contain lactose.
• D. Increase your intake of potassium-rich foods.

Correct answer: B

Rationale: In chronic kidney disease, decreasing the intake of phosphorus-rich foods is essential as impaired kidney function can lead to difficulty in excreting phosphorus, causing an imbalance. This can result in bone and heart complications. Therefore, educating the client to reduce phosphorus intake is crucial for managing the disease and preventing further complications. Option A is incorrect because excessive protein intake can burden the kidneys. Option C is not directly related to the management of chronic kidney disease. Option D is also incorrect as potassium intake may need to be limited in certain stages of kidney disease.

4. A client with chronic kidney disease is being educated by a nurse about dietary management. Which of the following statements by the client indicates an understanding of the teaching?

• A. I should limit my intake of protein to prevent overworking my kidneys.
• B. I should increase my intake of potassium-rich foods.
• C. I should increase my intake of phosphorus-rich foods.
• D. I should increase my intake of calcium-rich foods.

Correct answer: A

Rationale: The correct answer is A. In chronic kidney disease, limiting protein intake is crucial to prevent overworking the kidneys. Excessive protein consumption can lead to the accumulation of metabolic waste products that the kidneys struggle to process, worsening kidney function. Therefore, by recognizing the need to restrict protein intake, the client demonstrates an understanding of the dietary management required for their condition. Choices B, C, and D are incorrect. Increasing intake of potassium-rich foods (Choice B) is not recommended in chronic kidney disease as it can lead to hyperkalemia. Similarly, increasing intake of phosphorus-rich foods (Choice C) is not advised because impaired kidneys struggle to excrete phosphorus, leading to elevated levels in the blood. Lastly, increasing intake of calcium-rich foods (Choice D) may not be necessary unless there is a specific deficiency or requirement, as calcium balance is often disrupted in chronic kidney disease.

5. A client with pancreatitis is being taught about dietary management. Which of the following statements by the client indicates an understanding of the teaching?

• A. I should increase my intake of high-fat foods.
• B. I should decrease my intake of high-fat foods.
• C. I should increase my intake of high-protein foods.
• D. I should decrease my intake of high-protein foods.

Correct answer: B

Rationale: The correct answer is B. Decreasing the intake of high-fat foods is essential in managing pancreatitis as high-fat foods can exacerbate symptoms and lead to complications. By reducing high-fat foods in their diet, the client demonstrates an understanding of the dietary management needed for pancreatitis. Choices A, C, and D are incorrect. Increasing high-fat foods (Choice A) is not recommended for pancreatitis as it can worsen the condition. While high-protein foods (Choice C) can be beneficial in some cases, the primary focus in pancreatitis management is on reducing fat intake. Decreasing high-protein foods (Choice D) is not a key dietary management approach for pancreatitis.

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