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. The nurse asks a client who is about to have a cardiac catheterization about any allergies. The client states, 'I always get a rash when I eat shellfish.' Which of the following is the priority nursing action?

• A. Attach a wristband indicating the client's allergy
• B. Ask the client if any other foods cause such a reaction
• C. Notify the dietary department of the client's allergy
• D. Notify the provider of the client's allergy

Correct answer: D

Rationale: Notifying the provider of the client's shellfish allergy is crucial to prevent a potential reaction from the contrast dye. While attaching a wristband indicating the allergy may be necessary, the priority is to inform the provider. Asking the client about other foods causing a similar reaction or notifying the dietary department, although important, are not the priority in this situation.

3. What is the primary intervention for a client diagnosed with delirium?

• A. Provide a quiet and calm environment to minimize confusion
• B. Administer medication to reverse the symptoms of delirium
• C. Provide opportunities for social interaction to reduce isolation
• D. Encourage the client to remain physically active

Correct answer: A

Rationale: The correct answer is A: Provide a quiet and calm environment to minimize confusion. For clients diagnosed with delirium, creating a tranquil setting can help reduce agitation and disorientation. This intervention aims to decrease stimuli that may exacerbate symptoms. Administering medication (choice B) is not the primary intervention for delirium; it is usually reserved for specific underlying causes. While social interaction (choice C) and physical activity (choice D) are beneficial for overall well-being, they are not the primary interventions for managing delirium.

4. 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.

5. While reviewing a client's chart, a nurse notices a discrepancy in the medication record. What should the nurse do?

• A. Correct the discrepancy and document the correction.
• B. Report the discrepancy to the nurse manager.
• C. Ignore the discrepancy assuming it is a clerical error.
• D. Discuss the discrepancy with the client and adjust the records.

Correct answer: B

Rationale: Reporting medication discrepancies to the nurse manager is crucial to ensure patient safety and proper follow-up. The nurse manager is responsible for addressing medication errors and implementing necessary corrective actions. Choice A is incorrect because simply correcting the discrepancy without reporting it may lead to potential harm to the patient and violates professional standards. Choice C is incorrect as ignoring the discrepancy increases the risk of medication errors going unresolved. Choice D is incorrect because discussing the discrepancy with the client before verifying the accuracy of the record can cause confusion and compromise patient safety.

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