Nursing Elites

1. A nurse is teaching an older adult client who reports constipation. Which of the following instructions should the nurse include in the teaching?

• A. Increase dietary intake of raw vegetables
• B. Limit activity
• C. Drink four to five glasses of water daily
• D. Bear down hard when defecating

Correct answer: C

Rationale: The correct instruction the nurse should include is to advise the client to drink four to five glasses of water daily. Increasing water intake helps alleviate constipation by softening stool and increasing bowel movements. Choice A, increasing dietary intake of raw vegetables, can be helpful in preventing constipation but may not be sufficient as the sole intervention for someone already experiencing constipation. Choice B, limiting activity, can worsen constipation as physical activity helps stimulate bowel movements. Choice D, bearing down hard when defecating, can lead to other issues like hemorrhoids and should be avoided.

2. What are the nursing interventions for a patient with acute kidney injury (AKI)?

• A. Preparing the patient for dialysis if necessary
• B. Providing dietary modifications to reduce potassium
• C. Monitoring urine output and electrolytes
• D. Administering fluids and monitoring blood pressure

Correct answer: A

Rationale: The correct nursing intervention for a patient with acute kidney injury (AKI) includes preparing the patient for dialysis if necessary. While choices B, C, and D are also important aspects of managing AKI, the critical intervention in severe cases is to prepare the patient for dialysis to support kidney function. Providing dietary modifications to reduce potassium, monitoring urine output and electrolytes, and administering fluids are essential components of the overall care plan for AKI patients, but in cases where the condition is severe or if conservative management fails, dialysis may be required to support the patient's kidney function and prevent further complications.

3. A nurse is providing discharge instructions to a client following a gastrectomy. Which of the following strategies should the nurse include in the teaching?

• A. Drink fluids between meals
• B. Eat three large meals each day
• C. Lie down for 30 minutes after meals
• D. Avoid drinking liquids with meals

Correct answer: D

Rationale: The correct strategy to include in the teaching after a gastrectomy is to avoid drinking liquids with meals. This helps prevent dumping syndrome, a condition characterized by rapid emptying of undigested food and fluids from the stomach into the small intestine. Choices A, B, and C are incorrect. Drinking fluids between meals is appropriate to maintain hydration, eating three large meals can exacerbate dumping syndrome, and lying down after meals is not recommended as it can increase the risk of reflux.

4. A client with hypertension is prescribed atenolol. Which of the following findings should the nurse include as adverse effects of this medication?

• A. Cough
• B. Tremor
• C. Constipation
• D. Bradycardia

Correct answer: D

Rationale: Correct. Bradycardia is a known adverse effect of atenolol, a beta-blocker medication commonly used to treat hypertension. Atenolol can slow down the heart rate, leading to bradycardia. The nurse should monitor the client for signs of bradycardia, such as dizziness, fatigue, or fainting. Choices A, B, and C are incorrect because cough, tremor, and constipation are not typically associated with atenolol use.

5. A patient has just undergone a tracheostomy. What is the nurse's priority intervention?

• A. Suction the tracheostomy to maintain a patent airway.
• B. Administer pain medication as prescribed.
• C. Change the tracheostomy dressing every 4 hours.
• D. Monitor the patient's oxygen saturation closely.

Correct answer: A

Rationale: The correct answer is to suction the tracheostomy to maintain a patent airway. After a tracheostomy, the priority intervention is to ensure a clear airway to prevent respiratory distress. Administering pain medication, changing the tracheostomy dressing, and monitoring oxygen saturation are important but are secondary to maintaining a patent airway in a patient who has just undergone a tracheostomy.

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