Nursing Elites

1. A client with chronic kidney disease is being taught about dietary modifications by a nurse. Which of the following foods should the nurse instruct the client to avoid?

• A. Grilled chicken.
• B. Fresh fruit.
• C. White bread.
• D. Cheddar cheese.

Correct answer: D

Rationale: Cheddar cheese is high in phosphorus, which should be avoided by clients with chronic kidney disease. Fresh fruit is generally a healthy choice unless the client needs to limit potassium intake. Grilled chicken is a good protein source for clients with chronic kidney disease. White bread is low in phosphorus and can be included in the diet of clients with kidney disease unless they need to watch their carbohydrate intake.

2. What is the appropriate action when a patient presents with chest pain?

• A. Administer aspirin
• B. Administer nitroglycerin
• C. Reposition the patient
• D. Prepare for surgery

Correct answer: A

Rationale: The appropriate action when a patient presents with chest pain is to administer aspirin. Aspirin helps reduce the risk of clot formation by inhibiting platelet aggregation, which can be beneficial in cases of myocardial infarction. Nitroglycerin is commonly used for chest pain related to angina but is not the first-line treatment for all types of chest pain. Repositioning the patient may be necessary for comfort or assessment but is not the immediate priority. Surgery is not typically the first-line intervention for chest pain unless there are specific indications.

3. A nurse is providing teaching about immunizations to a client who is pregnant. The nurse should inform the client that she can receive which of the following immunizations during pregnancy?

• A. Varicella vaccine.
• B. Inactivated polio vaccine.
• C. Tetanus diphtheria and acellular pertussis vaccine.
• D. Inactivated influenza vaccine.

Correct answer: C

Rationale: The correct answer is C: Tetanus diphtheria and acellular pertussis (Tdap) vaccine. The Tdap vaccine can be safely administered during pregnancy to protect both the mother and the newborn against whooping cough. Choices A, B, and D are incorrect because the Varicella vaccine, Inactivated polio vaccine, and Inactivated influenza vaccine are generally not recommended during pregnancy due to safety concerns.

4. A nurse is caring for a client who has experienced a stroke and has aphasia. Which of the following communication strategies should the nurse use?

• A. Speak louder to help the client understand
• B. Speak using simple sentences and gestures
• C. Use a picture board to facilitate communication
• D. Have the client practice writing words down

Correct answer: C

Rationale: The correct answer is to use a picture board to facilitate communication. Aphasia can make it challenging for individuals to understand and use language. Using a picture board can help the client convey their needs and understand information more effectively. Speaking louder (A) may not be helpful as aphasia is not related to hearing loss. While speaking using simple sentences and gestures (B) can be beneficial, using a picture board (C) is a more concrete and visual method to support communication for individuals with aphasia. Having the client practice writing words down (D) may not be suitable if the client's expressive language skills are impaired due to aphasia.

5. A client is 2 hours postoperative following a total knee arthroplasty. Which of the following findings should the nurse report to the provider?

• A. Heart rate 88/min
• B. Capillary refill of 2 seconds
• C. Pain level of 8 on a scale of 0 to 10
• D. Temperature of 37.8°C (100°F)

Correct answer: C

Rationale: A pain level of 8 is high and may indicate inadequate pain control or complications following surgery. Monitoring and managing pain is crucial postoperatively to ensure patient comfort and prevent complications. A heart rate of 88/min, capillary refill of 2 seconds, and a temperature of 37.8°C (100°F) are within normal ranges and do not typically require immediate reporting unless in the context of other concerning signs or symptoms.

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