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 healthcare provider notices a discrepancy in the narcotics log. What is the appropriate response?

• A. Correct the narcotics log and move on.
• B. Report the discrepancy to the supervisor.
• C. Confront the provider responsible for the discrepancy.
• D. Dispose of the medication and ignore the discrepancy.

Correct answer: B

Rationale: When a healthcare provider notices a discrepancy in the narcotics log, the appropriate response is to report the issue to the supervisor. Reporting discrepancies is crucial to maintain accountability and prevent potential misuse. Choice A is incorrect because simply correcting the log without addressing the underlying issue does not ensure accountability. Choice C is inappropriate as confronting the provider directly may not be the best approach and could lead to a confrontational situation. Choice D is highly inappropriate as ignoring the discrepancy and disposing of medication without proper documentation can lead to serious consequences.

3. A healthcare professional is planning care for a client who is scheduled for a lumbar puncture. Which of the following actions should the healthcare professional include?

• A. Restrict the client's fluid intake for 4 hours following the procedure
• B. Apply cold compresses to the puncture site after the procedure
• C. Instruct the client to increase oral fluid intake after the procedure
• D. Keep the client in a prone position for 12 hours after the procedure

Correct answer: C

Rationale: The correct action to include in caring for a client scheduled for a lumbar puncture is to instruct the client to increase oral fluid intake after the procedure. Increasing oral fluid intake helps replace cerebrospinal fluid lost during the lumbar puncture and reduces the risk of headaches. Restricting fluid intake (Choice A) is not recommended as it can lead to dehydration. Applying cold compresses (Choice B) is not necessary after a lumbar puncture. Keeping the client in a prone position for 12 hours (Choice D) is not required after a lumbar puncture and can cause discomfort and complications.

4. A nurse is preparing to administer enoxaparin subcutaneously to a client. Which of the following actions should the nurse take?

• A. Inject at a 90-degree angle
• B. Inject at a 45-degree angle
• C. Massage the injection site after administering
• D. Use a longer needle

Correct answer: B

Rationale: The correct answer is to inject enoxaparin subcutaneously at a 45-degree angle. This angle helps ensure proper delivery of the medication into the subcutaneous tissue. Option A (Inject at a 90-degree angle) is incorrect because subcutaneous injections are usually given at a shallower angle. Option C (Massage the injection site after administering) is incorrect as massaging the site can cause bruising and should generally be avoided. Option D (Use a longer needle) is incorrect as using a longer needle is unnecessary and may increase the risk of injecting the medication too deeply.

5. A patient has difficulty ambulating after surgery. Which action should the nurse take first?

• A. Encourage deep breathing exercises.
• B. Assist the patient in ambulating a short distance.
• C. Call for assistance with ambulation.
• D. Assess the patient's pain level before ambulation.

Correct answer: C

Rationale: The correct first action for the nurse to take when a patient has difficulty ambulating after surgery is to call for assistance with ambulation. This is essential to ensure the safety of the patient and prevent any potential falls or injuries. Encouraging deep breathing exercises (Choice A) may be beneficial but should not be the first priority when the patient is having difficulty walking. Assisting the patient in ambulating a short distance (Choice B) may put both the patient and the nurse at risk if the patient is struggling. Assessing the patient's pain level before ambulation (Choice D) is important but should come after ensuring that the patient can safely ambulate with assistance.

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