Nursing Elites

1. The client with chronic renal failure who is on a low-sodium diet should avoid which of the following foods?

• A. Fresh fruits.
• B. Canned soups.
• C. Lean meats.
• D. Whole grain bread.

Correct answer: B

Rationale: Canned soups are high in sodium, which can lead to fluid retention and hypertension in clients with chronic renal failure who are on a low-sodium diet. Fresh fruits, lean meats, and whole grain bread are generally lower in sodium and can be included in a low-sodium diet. Lean meats provide essential protein, fresh fruits offer vitamins and minerals, and whole grain bread provides fiber, making them suitable choices for individuals with chronic renal failure.

2. When preparing a client who has had a total laryngectomy for discharge, what instruction is most important for the nurse to include in the discharge teaching?

• A. Recommend that the client carry suction equipment at all times.
• B. Instruct the client to have writing materials with them at all times.
• C. Tell the client to carry a medic alert card stating that they are a total neck breather.
• D. Tell the client not to travel alone.

Correct answer: C

Rationale: The most crucial instruction for a client who has had a total laryngectomy is to carry a medic alert card stating that they are a total neck breather. This is important because if they experience a cardiac arrest, mouth-to-neck breathing may be required. Choice A about carrying suction equipment is not the most critical as the client may not always need it. Choice B is not as essential as having a medic alert card. Choice D is not directly related to the client's safety due to their laryngectomy.

3. The nurse is caring for a patient whose serum sodium level is 140 mEq/L and serum potassium level is 5.4 mEq/L. The nurse will contact the patient’s provider to discuss an order for

• A. a low-potassium diet.
• B. intravenous sodium bicarbonate.
• C. Kayexalate and sorbitol.
• D. salt substitutes.

Correct answer: A

Rationale: In the scenario presented, the patient is experiencing mild hyperkalemia with a potassium level of 5.4 mEq/L. The appropriate intervention for mild hyperkalemia is a low-potassium diet to restrict potassium intake. This helps in managing and preventing further elevation of potassium levels. Intravenous sodium bicarbonate is not indicated as the patient's sodium level is normal at 140 mEq/L. Kayexalate, a cation-exchange resin, is typically used for severe hyperkalemia to promote potassium excretion. Salt substitutes, which often contain potassium chloride, should be avoided in patients with hyperkalemia as they can exacerbate the condition by increasing potassium levels further.

4. A client who has just undergone bronchoscopy was returned to the nursing unit 1 hour ago. With which assessment finding is the nurse most concerned?

• A. Oxygen saturation of 97%
• B. Equal breath sounds in both lungs
• C. Absence of cough and gag reflexes
• D. Respiratory rate of 20 breaths/min

Correct answer: C

Rationale: The correct answer is C. The absence of cough and gag reflexes is the most concerning finding for the nurse because it indicates a lack of protective airway reflexes, putting the client at risk of aspiration. Oxygen saturation of 97% is within the normal range and indicates adequate oxygenation. Equal breath sounds in both lungs are a positive finding, indicating no significant abnormalities. A respiratory rate of 20 breaths/min is also within the normal range and does not raise immediate concerns. Therefore, the absence of cough and gag reflexes poses the highest risk to the client's airway safety.

5. Which of the following is a common cause of acute kidney injury?

• A. Hypertension
• B. Dehydration
• C. Infection
• D. Hypotension

Correct answer: C

Rationale: Infection is a common cause of acute kidney injury because when the body fights an infection, it activates the immune response, leading to inflammation. This inflammatory response can affect the kidneys and impair their function. While hypertension (choice A) is a risk factor for chronic kidney disease, it is not a direct cause of acute kidney injury. Dehydration (choice B) can lead to prerenal acute kidney injury due to decreased blood flow to the kidneys, but infection is a more common cause of acute kidney injury. Hypotension (choice D) can contribute to prerenal acute kidney injury, but it is not a direct cause like infection.

Similar Questions