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 food has the highest calcium content?

• A. 1 cup of carrot strips
• B. 3 oz of canned salmon
• C. 1 plain baked potato
• D. 1 cup of chopped chicken breast

Correct answer: B

Rationale: The highest source of calcium among the given choices is the 3 oz of canned salmon. This is due to the presence of bones in canned salmon, which are rich in calcium. The other options, including 1 cup of carrot strips, 1 plain baked potato, and 1 cup of chopped chicken breast, do not contain as much calcium due to the nature of their composition and lack of bone content.

3. When taking a blood pressure reading, where should the cuff be positioned?

• A. The cuff should be deflated fully before immediately starting a second reading for the same patient
• B. The cuff should be deflated quickly after being inflated to 180 mmHg
• C. The cuff should be large enough to wrap around the upper arm of the adult patient, positioned 1 cm above the brachial artery
• D. The cuff should be inflated to 30 mmHg above the estimated systolic BP based on palpation of the radial or brachial artery

Correct answer: D

Rationale: When measuring blood pressure, the cuff should be inflated to 30 mmHg above the estimated systolic blood pressure based on palpation of the radial or brachial artery. This ensures an accurate blood pressure measurement. Choices A, B, and C are incorrect. Deflating the cuff fully before starting a second reading (Choice A) does not directly relate to the position of the cuff during a reading. Deflating the cuff quickly after inflating to 180 mmHg (Choice B) is not recommended because it can potentially lead to inaccurate readings. While ensuring the cuff is large enough to wrap around the upper arm positioned 1 cm above the brachial artery is important (Choice C), this alone does not guarantee an accurate blood pressure reading. The correct inflation based on palpation is the key element for accuracy, which is why Choice D is correct.

4. In order to establish a therapeutic relationship with the client, the nurse must first have:

• A. Self awareness C. Self acceptance
• B. Self understanding D. Self motivation
• C.
• D.

Correct answer: D

Rationale: Understanding the underlying pathology and therapeutic techniques ensures that nursing care is not only reactive but also preventative, reducing the risk of complications.

5. A client with iron deficiency anemia is being taught about dietary recommendations by a nurse. Which of the following dietary recommendations should the nurse include as a food that enhances iron absorption when consumed with nonheme iron?

• A. Tomato juice
• B. Tea
• C. Milk
• D. Dried Beans

Correct answer: A

Rationale: Tomato juice is the correct answer because it contains vitamin C, which enhances the absorption of nonheme iron. Vitamin C helps convert nonheme iron into a form that is easier for the body to absorb. Tea and milk should be avoided when consuming nonheme iron as they can inhibit iron absorption. Dried beans, although a good source of iron, do not enhance iron absorption when consumed with nonheme iron.

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