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. During which phase of the therapeutic relationship should the nurse inform the patient about the termination of therapy?

• A. Pre-orientation
• B. Orientation
• C. Working
• D. Termination

Correct answer: D

Rationale: The correct answer is 'Termination'. This phase of the therapeutic relationship is when the nurse informs the patient about the conclusion of therapy. It is during this phase that the nurse and the patient review the goals and progress made and also discuss the upcoming termination. The other phases are not the appropriate times for discussing termination. 'Pre-orientation' is the phase before the nurse-patient relationship is established; 'Orientation' is when the nurse and patient get to know each other and set goals; and 'Working' is when these goals are pursued. Therefore, choices A, B, and C are incorrect.

3. When doing an initial assessment, the best way for you to identify the client’s priority problem is to:

• A. Interview the client for chief complaints and other symptoms
• B. Talk to the relatives to gather data about history of illness
• C. Do auscultation to check for chest congestion
• D. Do a physical examination while asking the client relevant questions

Correct answer: B

Rationale: Nursing interventions should be grounded in a deep understanding of the physiological processes involved, ensuring that care provided is both effective and efficient.

4. A nurse that is always ready to answer for all his actions and decision is said to be:

• A. Accountable C. Critical thinker
• B. Responsible D. Assertive
• C.
• D.

Correct answer: A

Rationale: Patient safety and efficacy of care depend on actions rooted in established nursing protocols that consider both the immediate and long-term needs of the patient.

5. Starting material for sex hormones:

• A. cholesterol
• B. phospholipid
• C. saturated
• D. triglyceride

Correct answer: A

Rationale: Cholesterol is a precursor for the synthesis of sex hormones like estrogen and testosterone.

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