Nursing Elites

1. What dietary changes should a patient with GERD make to manage their symptoms?

• A. Avoid mint and spicy foods
• B. Eat large, frequent meals
• C. Consume liquids with meals
• D. Eat small, frequent meals

Correct answer: A

Rationale: The correct answer is A: Avoid mint and spicy foods. Patients with GERD should avoid foods like mint and spicy dishes as they can trigger symptoms by increasing gastric acid secretion. Choices B, C, and D are incorrect. Eating large, frequent meals can exacerbate GERD symptoms by putting more pressure on the lower esophageal sphincter, consuming liquids with meals can lead to increased reflux, and eating small, frequent meals is the recommended approach to reduce symptoms and manage GERD.

2. What are the signs and symptoms of a hemorrhagic stroke?

• A. Sudden severe headache, decreased level of consciousness, and seizures
• B. Loss of consciousness and weakness
• C. Temporary vision loss
• D. Severe chest pain and shortness of breath

Correct answer: A

Rationale: The correct answer is A. A hemorrhagic stroke often presents with a sudden severe headache, decreased level of consciousness, and seizures due to bleeding in the brain. Choice B, loss of consciousness and weakness, is more indicative of an ischemic stroke where a clot blocks blood flow to the brain. Choice C, temporary vision loss, is more commonly seen in conditions like transient ischemic attacks (TIAs) or retinal migraines. Choice D, severe chest pain and shortness of breath, are symptoms more associated with cardiac issues like a heart attack.

3. 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.

4. How does hyponatremia place the patient at risk?

• A. Seizures
• B. Fatigue
• C. Cardiac dysrhythmias
• D. Muscle weakness

Correct answer: C

Rationale: Hyponatremia places the patient at risk for cardiac dysrhythmias. While hyponatremia can lead to seizures due to cerebral edema caused by fluid imbalance, the most immediate and life-threatening risk is cardiac dysrhythmias. Low sodium levels can disrupt the heart's electrical activity, potentially leading to fatal arrhythmias. Although fatigue and muscle weakness are symptoms of hyponatremia, cardiac dysrhythmias pose the most critical concern as they can have severe consequences.

5. What lab value should be prioritized for monitoring in a patient with HIV?

• A. CD4 T-cell count below 180 cells/mm3
• B. Hemoglobin levels
• C. Serum albumin levels
• D. White blood cell count

Correct answer: A

Rationale: The correct answer is A: CD4 T-cell count below 180 cells/mm3. Monitoring CD4 T-cell count is crucial in patients with HIV as it reflects the status of their immune system. A CD4 count below 200 cells/mm3 is indicative of severe immunocompromise, necessitating close monitoring and potential intervention. Choices B, C, and D are less specific to HIV management and do not directly reflect the immune status in these patients. Hemoglobin levels are more relevant for assessing anemia, serum albumin levels for nutritional status, and white blood cell count for overall immune response, but none are as directly tied to HIV disease progression as the CD4 T-cell count.

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