Nursing Elites

1. A client with a new diagnosis of type 2 diabetes mellitus is being taught about dietary management. Which of the following statements should the nurse include in the teaching?

• A. You should avoid foods that contain carbohydrates.
• B. You should decrease your intake of high-fiber foods.
• C. You should increase your intake of high-protein foods.
• D. You should monitor your carbohydrate intake.

Correct answer: D

Rationale: The correct answer is D: 'You should monitor your carbohydrate intake.' Monitoring carbohydrate intake is essential for managing blood glucose levels in clients with type 2 diabetes mellitus. By monitoring carbohydrate intake, individuals can make informed decisions about their dietary choices and better control their blood sugar levels. Avoiding foods that contain carbohydrates (choice A) is not advisable as carbohydrates are an essential nutrient that can be consumed in moderation. Decreasing intake of high-fiber foods (choice B) is not recommended as fiber is beneficial for glycemic control and overall health. Increasing intake of high-protein foods (choice C) is not the primary focus of dietary management for type 2 diabetes; while protein is important, it is more crucial to monitor carbohydrate intake for effective blood sugar management.

2. A healthcare provider is caring for a client who is receiving IV therapy via a peripheral catheter. The healthcare provider should identify that which of the following findings is an indication of infiltration?

• A. Redness at the infusion site
• B. Edema at the infusion site
• C. Warmth at the infusion site
• D. Oozing of blood at the infusion site

Correct answer: B

Rationale: Edema at the infusion site is an indication of infiltration, where fluid leaks into the surrounding tissues causing swelling. This can compromise the delivery of medication and fluids, potentially leading to complications. Redness, warmth, and oozing of blood are more suggestive of inflammation or infection rather than infiltration. Infiltration requires prompt recognition and intervention to prevent further issues with the IV therapy.

3. A client receives education on dietary management for ulcerative colitis from a nurse. Which of the following statements should the nurse include in the teaching?

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

Correct answer: C

Rationale: The correct statement the nurse should include in the teaching is to decrease the intake of dairy products. This is because reducing the intake of dairy products is beneficial in managing symptoms of ulcerative colitis. Dairy products can aggravate symptoms due to their lactose content, thus advising the client to decrease their consumption can help alleviate discomfort and promote better management of the condition.\nChoice A is incorrect because increasing high-fiber foods may worsen symptoms in some individuals with ulcerative colitis.\nChoice B is incorrect as while it is advised to avoid foods containing lactose, this alone does not encompass the full dietary management for ulcerative colitis.\nChoice D is incorrect as increasing the intake of dairy products can exacerbate symptoms in individuals with ulcerative colitis due to their lactose content.

4. A client is receiving continuous enteral feedings through a nasogastric tube. Which of the following actions should the nurse take?

• A. Elevate the head of the bed to 30°
• B. Flush the tube with 50 mL of water every 2 hours
• C. Replace the feeding bag and tubing every 72 hours
• D. Check the client's gastric residual every 8 hours

Correct answer: A

Rationale: Elevating the head of the bed to 30° is the correct action to take when a client is receiving continuous enteral feedings through a nasogastric tube. This position helps prevent aspiration of the enteral feedings into the lungs, reducing the risk of aspiration pneumonia. Additionally, elevating the head of the bed promotes proper digestion and absorption of the feedings by utilizing gravity to facilitate movement into the stomach and through the gastrointestinal tract. Flushing the tube with water every 2 hours (Choice B) is not necessary for continuous feedings and may disrupt the feeding schedule. Replacing the feeding bag and tubing every 72 hours (Choice C) is not the standard recommendation unless there are specific concerns or complications. Checking the client's gastric residual every 8 hours (Choice D) is important but not the immediate action needed to prevent aspiration during enteral feedings.

5. A client has a new diagnosis of GERD. Which of the following statements should the nurse include in the teaching about dietary management?

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

Correct answer: B

Rationale: The correct answer is to decrease the intake of high-fat foods. High-fat foods can exacerbate symptoms of GERD by delaying stomach emptying and increasing the risk of reflux. By reducing high-fat foods in the diet, the client can help manage symptoms of GERD and decrease the likelihood of complications. Choice A is incorrect because increasing high-fat foods can worsen GERD symptoms. Choice C is unrelated as gluten is not a specific concern for GERD. Choice D is incorrect as increasing dairy products may lead to increased fat intake, which is not recommended for GERD.

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