Nursing Elites

1. 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.

2. A client with dysphagia and at risk for aspiration needs care planning. Which intervention should the nurse include in the plan?

• A. Encourage the client to drink thickened liquids.
• B. Instruct the client to swallow with chin tucked.
• C. Provide the client with a cup with a lid.
• D. Place the client in Fowler's position for meals.

Correct answer: D

Rationale: Placing the client in Fowler's position is crucial in preventing aspiration as it helps maintain an open airway and reduces the risk of food or liquid entering the lungs during swallowing. This position promotes safer swallowing and minimizes the chances of aspiration pneumonia. Choices A, B, and C are less effective interventions for preventing aspiration. Encouraging the client to drink thickened liquids may help, but the position is more critical. Instructing the client to swallow with chin tucked is beneficial for some individuals but not as effective as positioning. Providing a cup with a lid does not directly address the risk of aspiration associated with dysphagia.

3. A healthcare professional is preparing to administer an intramuscular (IM) injection to a client. Which of the following actions should the healthcare professional take?

• A. Use a 1-inch needle.
• B. Insert the needle at a 45-degree angle.
• C. Aspirate before injecting the medication.
• D. Administer the injection in the deltoid muscle.

Correct answer: C

Rationale: Aspirating before injecting the medication is a crucial step in IM injections to check for blood return, ensuring that the needle is not in a blood vessel. This technique helps prevent accidental intravascular injection of the medication, reducing the risk of complications such as inadvertent intravenous administration of the substance.

4. 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.

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

• A. I should avoid drinking milk.
• B. I should avoid drinking coffee.
• C. I should avoid eating high-fiber foods.
• D. I should avoid eating low-fat foods.

Correct answer: B

Rationale: The correct answer is B. Avoiding coffee is important in managing peptic ulcer disease as it helps reduce acid production and alleviate symptoms. Coffee is known to stimulate acid secretion in the stomach, which can exacerbate ulcer symptoms. Therefore, instructing the client to avoid drinking coffee is essential in the dietary management of peptic ulcer disease. Choices A, C, and D are incorrect. Drinking milk is generally allowed and can even provide a protective effect against ulcers. High-fiber foods are beneficial for digestion and do not need to be avoided unless they cause discomfort. Low-fat foods are also typically recommended for individuals with peptic ulcer disease as they are easier on the digestive system.

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