Nursing Elites

1. A patient with chronic kidney disease has been prescribed a low-protein diet. What is the nurse's priority intervention?

• A. Encourage the patient to eat small, frequent meals.
• B. Monitor the patient's intake and output.
• C. Educate the patient on the benefits of a low-protein diet.
• D. Monitor the patient's protein intake closely.

Correct answer: D

Rationale: The correct answer is to monitor the patient's protein intake closely. In patients with chronic kidney disease on a low-protein diet, monitoring protein intake is crucial to prevent complications such as malnutrition or inadequate nutrient intake. Encouraging small, frequent meals (Choice A) can be beneficial but is not the priority over monitoring protein intake. Monitoring intake and output (Choice B) is important but does not directly address the specific focus on protein intake. Educating the patient on the benefits of a low-protein diet (Choice C) is essential but not as immediate as monitoring the actual protein intake.

2. A client expresses concern about hair loss during chemotherapy. What should the nurse suggest?

• A. Encourage the client to cut their hair short before chemotherapy begins.
• B. Offer resources for wigs and head coverings.
• C. Assure the client that hair loss will be minimal.
• D. Ignore the client's concerns about hair loss.

Correct answer: B

Rationale: During chemotherapy, hair loss is a common side effect. Offering resources for wigs and head coverings can help the client cope with this change in appearance, maintain self-esteem, and feel more comfortable during the process. Encouraging the client to cut their hair short does not address the emotional impact of hair loss and may not be the client's preference. Assuring the client that hair loss will be minimal may provide false hope as significant hair loss is a common occurrence. Ignoring the client's concerns is not appropriate and goes against the principles of providing holistic and compassionate care.

3. A client with leukemia is considered for a bone marrow transplant. Which principle of healthcare ethics is being practiced by minimizing harm to the client?

• A. Justice
• B. Beneficence
• C. Nonmaleficence
• D. Autonomy

Correct answer: C

Rationale: The correct answer is C: Nonmaleficence. Nonmaleficence is the ethical principle that focuses on avoiding harm to the patient. In this scenario, by considering a bone marrow transplant for the client with leukemia, healthcare professionals are practicing nonmaleficence by aiming to minimize harm. Choice A, Justice, pertains to fairness in the distribution of resources and decisions, which is not the primary focus in this situation. Choice B, Beneficence, involves promoting the patient's well-being, which is related but not directly addressing the act of minimizing harm. Choice D, Autonomy, refers to respecting the patient's right to make decisions about their own care, which is not the key principle at play when minimizing harm in this context.

4. What are the nursing considerations when caring for a patient with chronic obstructive pulmonary disease (COPD)?

• A. Encouraging pursed-lip breathing to improve ventilation
• B. Administering bronchodilators and corticosteroids
• C. Monitoring oxygen saturation and ABGs
• D. Teaching the patient how to use an inhaler

Correct answer: A

Rationale: The correct answer is A. Pursed-lip breathing is a nursing consideration for patients with COPD as it helps improve oxygenation and reduces air trapping. While administering bronchodilators and corticosteroids (choice B) is part of the treatment plan, it is typically done by healthcare providers. Monitoring oxygen saturation and arterial blood gases (ABGs) (choice C) is important but not a direct nursing consideration. Teaching the patient how to use an inhaler (choice D) is relevant but not specific to COPD care.

5. When teaching a patient about self-administration of insulin, what is the most important instruction to provide?

• A. Rotate injection sites to prevent tissue damage.
• B. Inject insulin at a 90-degree angle for proper absorption.
• C. Store insulin in the refrigerator to maintain potency.
• D. Teach the patient to administer insulin at the same time each day.

Correct answer: A

Rationale: The most important instruction to provide when teaching a patient about self-administration of insulin is to rotate injection sites to prevent tissue damage. Rotating injection sites helps prevent lipodystrophy (tissue damage) and ensures proper insulin absorption. Option B is incorrect because the angle of insulin injection varies depending on the patient's body composition. Injecting at a 90-degree angle is not always necessary. Option C is not the most crucial instruction; while storing insulin in the refrigerator is important, it is not the priority when teaching self-administration. Option D is also important for maintaining consistency but is not as critical as rotating injection sites to prevent tissue damage.

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