Nursing Elites

1. A client with pre-dialysis end-stage kidney disease is being taught about diet. Which of the following instructions should the nurse include?

• A. Increase intake of dietary phosphorus.
• B. Eliminate foods high in protein from your diet.
• C. Reduce intake of foods high in potassium.
• D. Increase intake of sodium-containing foods.

Correct answer: C

Rationale: In pre-dialysis end-stage kidney disease, reducing intake of foods high in potassium is crucial as impaired kidney function can lead to potassium buildup in the blood, which can be dangerous. High potassium levels can cause irregular heartbeats and even cardiac arrest. Therefore, advising the client to reduce potassium-rich foods is essential to prevent complications. Choices A, B, and D are incorrect. Increasing dietary phosphorus, eliminating foods high in protein, or increasing sodium-containing foods are not appropriate recommendations for a client with pre-dialysis end-stage kidney disease as they can exacerbate the condition.

2. Which vitamin deficiency is most likely to cause bleeding disorders?

• A. Vitamin A
• B. Vitamin E
• C. Vitamin K
• D. Vitamin D

Correct answer: C

Rationale: Vitamin K is essential for blood clotting as it plays a crucial role in the activation of clotting factors. Deficiency of Vitamin K can lead to impaired blood clotting, resulting in bleeding disorders. Vitamin A is more associated with vision and skin health, not blood clotting. Vitamin E is known for its antioxidant properties and role in immune function, not specifically related to bleeding disorders. Vitamin D plays a key role in calcium absorption and bone health, but it is not directly linked to blood clotting or bleeding disorders.

3. A client who is postpartum and has been diagnosed with iron deficiency anemia should be taught to consume which of the following dietary recommendations?

• A. Yogurt and mozzarella
• B. Spinach and beef
• C. Milk and turkey slices
• D. Fish and cottage cheese

Correct answer: C

Rationale: The correct answer is spinach and beef. Both spinach and beef are high in iron, making them excellent choices to help combat iron deficiency anemia. Yogurt, mozzarella, milk, turkey slices, fish, and cottage cheese are not as rich in iron compared to spinach and beef, so they are not the most suitable dietary recommendations for a client with iron deficiency anemia.

4. Which client is most likely to need regular injections of vitamin B12?

• A. The client with malabsorption syndrome.
• B. The client following a vegan eating pattern.
• C. The client whose stomach does not produce intrinsic factors.
• D. The client with alcoholism.

Correct answer: C

Rationale: The correct answer is C. The client whose stomach does not produce intrinsic factors is most likely to need regular injections of vitamin B12. Intrinsic factor is essential for the absorption of vitamin B12. Without intrinsic factor, the client cannot absorb vitamin B12 from food, necessitating the need for regular injections. Choices A, B, and D do not directly impact the production of intrinsic factors in the stomach, so they are less likely to result in the need for vitamin B12 injections.

5. What symptoms would most likely be associated with a transient ischemic attack?

• A. confusion and difficulty speaking
• B. headache and blurred vision
• C. chest pain and pressure
• D. claudication and peripheral edema

Correct answer: A

Rationale: The correct answer is A: confusion and difficulty speaking. These symptoms are commonly associated with a transient ischemic attack (TIA), which is a temporary blockage of blood flow to the brain. Choice B, headache and blurred vision, are more indicative of other conditions such as migraines or eye problems. Choice C, chest pain and pressure, are more characteristic of cardiac issues like a heart attack. Choice D, claudication and peripheral edema, are typical of peripheral arterial disease and not typically seen in TIAs.

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