Nursing Elites

1. Symptoms of irritable bowel syndrome are most likely associated with disturbed defecation, bloating, and _____.

• A. rectal bleeding
• B. abdominal pain
• C. rectal fissures
• D. esophageal paralysis

Correct answer: B

Rationale: Abdominal pain is a common symptom of irritable bowel syndrome (IBS), along with bloating and changes in bowel habits. Rectal bleeding (choice A) is more commonly associated with conditions like inflammatory bowel disease or colorectal cancer. Rectal fissures (choice C) may cause rectal bleeding but are not typically considered a core symptom of IBS. Esophageal paralysis (choice D) is unrelated to the symptoms of IBS, which primarily affect the lower gastrointestinal tract.

2. For an incontinent elderly client who frequently wets his bed and develops redness and skin excoriation at the perianal area, what is the best nursing goal?

• A. Ensure that the bed linen is always dry
• B. Frequently check the bed for wetness and keep it dry
• C. Place a rubber sheet under the client's buttocks
• D. Keep the patient clean and dry

Correct answer: A

Rationale: The best nursing goal for an incontinent elderly client with skin excoriation is to ensure that the bed linen is always dry. This helps in preventing further skin breakdown and promoting skin integrity. Choice B, to frequently check the bed for wetness and keep it dry, may not address the issue of prevention if the linen is not consistently dry. Choice C, placing a rubber sheet under the client's buttocks, focuses more on protecting the mattress rather than addressing the client's skin condition directly. Choice D, keeping the patient clean and dry, is important but does not specifically address the preventive aspect of maintaining dry bed linen.

3. Which dietary modification is most suitable for a client with type 2 diabetes who wants to improve glycemic control?

• A. Increase intake of saturated fats
• B. Decrease intake of refined carbohydrates
• C. Completely avoid all fruits
• D. Increase intake of sugary snacks

Correct answer: B

Rationale: Decreasing the intake of refined carbohydrates is the most effective dietary modification for a client with type 2 diabetes who aims to improve their glycemic control. Refined carbohydrates can cause sudden spikes in blood sugar levels, making diabetes management more difficult. Increasing the intake of saturated fats (Choice A) is not advisable as it can negatively impact heart health. Completely avoiding all fruits (Choice C) is unnecessary because most fruits have a low glycemic index and provide essential nutrients. Increasing the intake of sugary snacks (Choice D) will deteriorate glycemic control due to their high sugar content.

4. A client is experiencing sleep disturbances and desires to decrease caffeine intake. Which of the following beverages should the nurse recommend?

• A. Lemon-lime soda
• B. Brewed iced tea
• C. Diet cola
• D. Chocolate milk

Correct answer: B

Rationale: The nurse should recommend brewed iced tea as it generally contains less caffeine compared to other choices. Lemon-lime soda, diet cola, and chocolate milk all contain caffeine, which can contribute to sleep disturbances. Lemon-lime soda and diet cola are carbonated beverages that typically contain caffeine unless specified as caffeine-free. Chocolate milk also contains caffeine due to the cocoa content. Therefore, brewed iced tea is the most suitable choice to reduce caffeine intake and improve sleep quality.

5. Mr. Bradley has been advised to limit his dairy product intake. What principle regarding fluid intake should be followed?

• A. Gelatin, soups, fruit ices, and frozen fruit bars contribute to your fluid intake
• B. Drink milk in moderation
• C. Increase fiber intake
• D. Limit protein intake

Correct answer: A

Rationale: For patients with kidney disease, it's important to manage fluid intake from all sources, including foods like gelatin and soups, which can contribute to fluid overload.

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