Nursing Elites

1. A patient with Crohn’s disease is experiencing diarrhea. Which dietary recommendation is appropriate?

• A. High-fiber diet
• B. Low-residue diet
• C. High-fat diet
• D. High-protein diet

Correct answer: B

Rationale: A low-residue diet is appropriate for a patient with Crohn’s disease experiencing diarrhea because it helps reduce bowel movements and manage symptoms. Choice A, a high-fiber diet, can exacerbate diarrhea in Crohn’s disease due to increased bulk and fermentation in the gut. Choice C, a high-fat diet, may be hard to digest and can worsen symptoms. Choice D, a high-protein diet, can be taxing on the digestive system and may not provide the relief needed for diarrhea in Crohn’s disease.

2. The nurse has been assigned to train the unlicensed nursing assistant about prioritizing care. Which client should the nurse instruct the unlicensed nursing assistant to see first?

• A. The client who needs both sequential compression devices removed
• B. The elderly woman who needs assistance ambulating to the bathroom
• C. The surgical client who needs help changing the gown after bathing
• D. The male client who needs the intravenous fluid discontinued

Correct answer: A

Rationale: The correct answer is A because removing sequential compression devices could increase the risk of thromboembolism, making it the priority. Choice B involves assisting with ambulation, which can be done after addressing the urgent need of the client in choice A. Choice C and D involve non-urgent tasks compared to the potential risks associated with not removing sequential compression devices promptly.

3. Which endocrine disorder would the nurse assess for in the client who has a closed head injury with increased intracranial pressure?

• A. Pheochromocytoma
• B. Diabetes insipidus
• C. Hashimoto's disease
• D. Gynecomastia

Correct answer: B

Rationale: The correct answer is B, Diabetes insipidus. Diabetes insipidus can develop after a head injury due to damage to the hypothalamus or pituitary gland, leading to a deficiency in antidiuretic hormone (ADH). Pheochromocytoma (Choice A) is a tumor of the adrenal gland that causes excessive release of catecholamines, leading to hypertension. Hashimoto's disease (Choice C) is an autoimmune condition affecting the thyroid gland. Gynecomastia (Choice D) refers to the enlargement of breast tissue in males and is not directly related to a closed head injury with increased intracranial pressure.

4. The client has recently been diagnosed with irritable bowel syndrome (IBS). Which intervention should the nurse teach the client to reduce symptoms?

• A. Instruct the client to avoid drinking fluids with meals
• B. Explain the need to decrease intake of flatus-forming foods
• C. Teach the client how to perform gentle perianal care
• D. Encourage the client to see a psychologist

Correct answer: B

Rationale: The correct answer is B. Decreasing the intake of flatus-forming foods can help reduce symptoms of bloating and discomfort in IBS. This intervention focuses on dietary modifications that can positively impact the client's condition. Instructing the client to avoid drinking fluids with meals (choice A) may not directly address the underlying cause of IBS symptoms. Teaching perianal care (choice C) is important for hygiene but does not directly address IBS symptoms. Encouraging the client to see a psychologist (choice D) may be beneficial for managing stress or anxiety associated with IBS but does not directly target symptom reduction through dietary changes.

5. Three major causes of atherosclerosis are:

• A. Hyperthyroidism, underweight, and poor appetite
• B. High blood cholesterol, high blood pressure, and cigarette smoking
• C. Constipation, peptic ulcer disease, and pancreatitis
• D. Kidney failure, edema, and sodium retention

Correct answer: B

Rationale: Atherosclerosis is primarily caused by high blood cholesterol, high blood pressure, and cigarette smoking. These factors contribute to the buildup of plaque in the arteries. Choices A, C, and D are incorrect. Hyperthyroidism, underweight, and poor appetite do not directly cause atherosclerosis. Similarly, constipation, peptic ulcer disease, pancreatitis, kidney failure, edema, and sodium retention are not among the primary causes of atherosclerosis.

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