Nursing Elites

1. What are the dietary recommendations for a patient with pre-dialysis end-stage kidney disease?

• A. Reduce phosphorus intake to 700 mg/day
• B. Limit sodium intake to 1,500 mg/day
• C. Restrict protein intake to 0.55-0.60 g/kg/day
• D. Increase protein intake

Correct answer: A

Rationale: The correct recommendation for a patient with pre-dialysis end-stage kidney disease is to reduce phosphorus intake to 700 mg/day. High phosphorus levels can be harmful to individuals with kidney disease as the kidneys may not be able to filter it effectively. While limiting sodium intake to 1,500 mg/day and restricting protein intake to 0.55-0.60 g/kg/day are important in managing kidney disease, the primary concern for this patient population is to control phosphorus levels. Increasing protein intake is not recommended as it can put additional strain on the kidneys. Therefore, option A is the most appropriate recommendation in this scenario.

2. What adverse effect might occur in a patient receiving radiation after a mastectomy?

• A. Seizures
• B. JVD and fatigue
• C. SOB and JVD
• D. S3 heart sound

Correct answer: D

Rationale: The correct adverse effect that might occur in a patient receiving radiation after a mastectomy is the development of an S3 heart sound. This can result from decreased pumping ability following mastectomy and radiation treatment. Choice A, seizures, is incorrect as seizures are not a common adverse effect of radiation after a mastectomy. Choice B, JVD and fatigue, is incorrect as while fatigue can be a common side effect, JVD (Jugular Venous Distention) is not typically associated with radiation after a mastectomy. Choice C, SOB (Shortness of Breath) and JVD, is incorrect as while shortness of breath can occur, JVD is not a typical adverse effect of radiation post-mastectomy.

3. What is the first-line treatment for wheezing due to an allergic reaction?

• A. Albuterol via nebulizer
• B. Cromolyn via nebulizer
• C. Methylprednisolone 100 mg IV
• D. Aminophylline 500 mg IV

Correct answer: A

Rationale: The correct answer is A, Albuterol via nebulizer. Albuterol is the first-line treatment for wheezing caused by an allergic reaction because it acts quickly to open the airways by relaxing the muscles in the air passages. Cromolyn (Choice B) is used for asthma prevention rather than acute wheezing. Methylprednisolone (Choice C) and Aminophylline (Choice D) are not the first-line treatments for acute wheezing in the setting of an allergic reaction.

4. A nurse is caring for a client who has increased intracranial pressure (ICP). Which of the following interventions should the nurse implement?

• A. Place several pillows behind the client's head
• B. Place the client in a Sim's position
• C. Keep the client's neck in a midline position
• D. Maintain flexion of the client's hips at a 90° angle

Correct answer: C

Rationale: Keeping the client's neck in a midline position is crucial for managing increased intracranial pressure. This position helps optimize blood flow and minimizes the risk of further increasing ICP. Placing several pillows behind the client's head (Choice A) may inadvertently elevate the head, potentially worsening ICP. Placing the client in a Sim's position (Choice B) or maintaining flexion of the client's hips at a 90° angle (Choice D) are not directly related to managing increased ICP.

5. When planning care for a patient with diabetes insipidus, what should the nurse include in the plan?

• A. Monitor serum albumin levels
• B. Avoid alcohol
• C. Teach the patient to increase fluids
• D. Increase exercise to reduce stress

Correct answer: B

Rationale: The correct answer is B: 'Avoid alcohol.' Alcohol consumption can exacerbate dehydration in patients with diabetes insipidus, so it is essential to advise them to avoid alcohol. Monitoring serum albumin levels (choice A) is not directly related to managing diabetes insipidus. Teaching the patient to increase fluids (choice C) is not recommended as it can worsen the condition by further diluting the urine. Increasing exercise to reduce stress (choice D) is not a primary intervention for managing diabetes insipidus.

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