Nursing Elites

1. A nurse is teaching a client who has hypertension about dietary modifications to help control blood pressure. Which of the following food choices should the nurse recommend as the best choice for the client to include in their diet?

• A. 1 packet of reconstituted dry onion soup
• B. 3 oz of lean cured ham
• C. 3 oz of chicken breast
• D. ½ cup of canned baked beans

Correct answer: C

Rationale: For a client with hypertension, a low sodium diet is recommended to help control blood pressure. Among the food choices provided, the best option is 3 oz of chicken breast. Chicken breast is lean protein with lower sodium content compared to other choices. It is a healthier option for managing hypertension. Reconstituted dry onion soup (Choice A) and canned baked beans (Choice D) typically contain higher amounts of sodium, which can be detrimental for blood pressure management. Lean cured ham (Choice B) also tends to have a higher sodium content, making it less suitable for a client with hypertension.

2. What should be done if a patient experiences abdominal cramping during enema administration?

• A. Lower the height of the enema solution container
• B. Stop the procedure and remove the tubing
• C. Continue the enema at a slower rate
• D. Increase the flow of the enema solution

Correct answer: A

Rationale: When a patient experiences abdominal cramping during enema administration, the appropriate action is to lower the height of the enema solution container. This adjustment helps alleviate the cramping by reducing the pressure of the solution entering the colon. Stopping the procedure and removing the tubing (Choice B) is not necessary unless there are other complications. Continuing the enema at a slower rate (Choice C) may not address the immediate discomfort caused by cramping. Increasing the flow of the enema solution (Choice D) can exacerbate the cramping and should be avoided.

3. What precaution should be advised to patients following cataract surgery?

• A. Wear dark glasses while outdoors
• B. Use warm compresses
• C. Avoid NSAIDs
• D. Avoid bright lights

Correct answer: A

Rationale: Patients who have undergone cataract surgery should wear dark glasses when outdoors to shield their eyes from light exposure, which can be uncomfortable or harmful during the recovery period. Using warm compresses (choice B) is not typically recommended after cataract surgery as it's more relevant for certain eye conditions. Avoiding NSAIDs (choice C) is advised to prevent bleeding complications, but it is not directly related to eye protection post-surgery. While avoiding bright lights (choice D) is crucial, wearing dark glasses provides a practical solution to achieve this, making choice A the most appropriate precaution.

4. What are the dietary instructions for a patient with pre-dialysis end-stage kidney disease?

• A. Increase protein intake
• B. Reduce sodium intake
• C. Reduce potassium intake
• D. Restrict protein intake to 0.55-0.60 g/kg/day

Correct answer: D

Rationale: The correct answer is to restrict protein intake to 0.55-0.60 g/kg/day for a patient with pre-dialysis end-stage kidney disease. Excessive protein intake can worsen kidney function in such patients. Increasing protein intake, as mentioned in choice A, is not recommended due to the strain it puts on the kidneys. While reducing sodium intake, as in choice B, is relevant for managing blood pressure, it is not specifically related to pre-dialysis end-stage kidney disease. Choice C, reducing potassium intake, is important for patients with kidney disease, but it is not the primary dietary instruction for those with pre-dialysis end-stage kidney disease.

5. What is the first intervention for a patient admitted with unstable angina?

• A. Administer nitroglycerin
• B. Obtain cardiac enzymes
• C. Start IV fluids
• D. Monitor for chest pain

Correct answer: A

Rationale: The correct first intervention for a patient admitted with unstable angina is to administer nitroglycerin. Nitroglycerin helps to relieve chest pain by dilating blood vessels and increasing blood flow to the heart, thereby reducing cardiac workload. This intervention aims to alleviate symptoms and prevent further cardiac damage. Obtaining cardiac enzymes (Choice B) is important for diagnosing a myocardial infarction but is not the initial intervention for unstable angina. Starting IV fluids (Choice C) may be indicated in specific cases like hypovolemia but is not the primary intervention for unstable angina. Monitoring for chest pain (Choice D) is essential but taking action to alleviate the pain, like administering nitroglycerin, is the primary focus in the initial management of unstable angina.

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