Nursing Elites

1. A client with cirrhosis 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 sodium-rich foods.
• B. I should decrease my intake of sodium-rich foods.
• C. I should increase my intake of potassium-rich foods.
• D. I should decrease my intake of potassium-rich foods.

Correct answer: B

Rationale: The correct answer is B. In cirrhosis, decreasing the intake of sodium-rich foods is essential to manage fluid retention and symptoms. Excessive sodium intake can worsen fluid accumulation and lead to complications such as ascites. Therefore, advising the client to decrease sodium-rich foods demonstrates an understanding of the dietary management necessary for cirrhosis. Choices A, C, and D are incorrect because increasing sodium-rich foods can exacerbate fluid retention and complications in cirrhosis, increasing potassium-rich foods is not the primary focus of dietary management in cirrhosis, and decreasing potassium-rich foods is not a key recommendation for managing cirrhosis-related dietary issues.

2. Prior to administering a blood transfusion, what should the healthcare professional do first?

• A. Prime the IV tubing with normal saline.
• B. Verify the client's identity.
• C. Obtain the blood product from the blood bank.
• D. Check the client's vital signs.

Correct answer: B

Rationale: Verifying the client's identity is the essential initial step before administering a blood transfusion. This action is crucial to confirm that the correct blood product is being administered to the right client, thereby preventing any potential errors or adverse reactions. Ensuring patient safety is paramount in healthcare, and verifying the client's identity is a fundamental safety measure that should always be prioritized.

3. A client has a new diagnosis of osteoarthritis and is being taught about dietary management. Which of the following statements should be included in the teaching?

• A. Increase your intake of calcium-rich foods.
• B. Avoid foods that are high in potassium.
• C. Increase your intake of vitamin D-rich foods.
• D. Avoid foods that are high in sodium.

Correct answer: C

Rationale: The correct statement to include in the teaching is to increase the intake of vitamin D-rich foods. Vitamin D helps improve calcium absorption, which is beneficial for bone health and may help alleviate symptoms of osteoarthritis. Option A is incorrect because while calcium is important for bone health, the focus should be on vitamin D for calcium absorption. Option B is incorrect as potassium is generally not restricted in osteoarthritis. Option D is also incorrect as sodium restriction is more relevant for conditions like hypertension or heart failure, not specifically for osteoarthritis.

4. A client has a new prescription for furosemide. Which of the following instructions should the nurse include during discharge teaching?

• A. Avoid foods high in potassium.
• B. Monitor weight daily.
• C. Take the medication with food.
• D. Increase salt intake.

Correct answer: B

Rationale: Monitoring weight daily is crucial when taking furosemide to detect fluid retention or loss. Furosemide is a diuretic that helps the body get rid of excess water and salt through urine. Changes in weight can indicate fluid shifts, which could be a sign of inadequate response to the medication or worsening condition. Therefore, monitoring weight daily is essential to assess the effectiveness of furosemide therapy and detect any potential issues early on. Choices A, C, and D are incorrect. Avoiding foods high in potassium is more relevant for clients taking potassium-sparing diuretics, not furosemide. Taking furosemide with food is not necessary, as it can be taken with or without food. Increasing salt intake is contradictory to the purpose of furosemide, which aims to eliminate excess salt from the body.

5. 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.

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