Nursing Elites

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

• A. Reduce phosphorus intake to 700 mg/day
• B. Increase sodium intake
• 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. Excessive phosphorus intake can be harmful to individuals with kidney disease as their kidneys may not be able to excrete it efficiently. Choice B is incorrect because increasing sodium intake is generally not recommended for patients with kidney disease, as it can contribute to fluid retention and high blood pressure. Choice C is incorrect as protein restriction is commonly advised for individuals with advanced kidney disease to reduce the workload on the kidneys. Choice D is also incorrect as increasing protein intake can further burden the kidneys.

2. What should the nurse monitor for in a patient with hypokalemia?

• A. Monitor for muscle weakness
• B. Check deep tendon reflexes (DTRs)
• C. Monitor for seizures
• D. Monitor for bradycardia

Correct answer: A

Rationale: The correct answer is to monitor for muscle weakness in a patient with hypokalemia. Hypokalemia, which is low potassium levels, can lead to muscle weakness due to its effects on neuromuscular function. Checking deep tendon reflexes (Choice B) is not typically associated with hypokalemia. Seizures (Choice C) are more commonly associated with low calcium levels rather than low potassium levels. Bradycardia (Choice D) is a symptom of hyperkalemia (high potassium levels) rather than hypokalemia.

3. A nurse is reviewing the medical record of a client who has unstable angina. Which of the following findings should the nurse report to the provider?

• A. Breath sounds
• B. Temperature
• C. Blood pressure
• D. Creatine kinase

Correct answer: A

Rationale: The correct answer is A: Breath sounds. When caring for a client with unstable angina, changes in breath sounds could indicate left ventricular failure and pulmonary edema due to decreased cardiac output and reduced cardiac perfusion. Reporting any abnormalities in breath sounds promptly to the provider is crucial to prevent further complications. Choices B, C, and D are not directly related to the immediate management of unstable angina. Temperature, blood pressure, and creatine kinase levels are important parameters to monitor but are not the priority in this situation.

4. What are the expected symptoms in a patient experiencing a thrombotic stroke?

• A. Gradual loss of function on one side of the body
• B. Sudden loss of consciousness
• C. Seizures and convulsions
• D. Severe headache and vomiting

Correct answer: A

Rationale: The correct answer is A: 'Gradual loss of function on one side of the body.' Thrombotic strokes typically result in a gradual onset of symptoms due to a blockage in a blood vessel in the brain, leading to a slow progression of neurological deficits. Choices B, C, and D are incorrect because sudden loss of consciousness, seizures, convulsions, severe headache, and vomiting are more commonly associated with other types of strokes or medical conditions, such as hemorrhagic strokes, epilepsy, or migraines.

5. What dietary recommendations should be provided for a patient with pre-dialysis end-stage kidney disease?

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

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. Excessive phosphorus can be harmful to individuals with kidney disease as the kidneys may not be able to effectively remove it from the body. Choices B, C, and D are incorrect. Increasing sodium intake is generally not recommended for patients with kidney disease as it can lead to fluid retention and high blood pressure. Restricting protein intake is important in later stages of kidney disease, but for pre-dialysis end-stage kidney disease, protein intake should be individualized based on the patient's condition. Limiting potassium-rich foods is more relevant for patients with advanced kidney disease or those on dialysis, as impaired kidney function can lead to high potassium levels in the blood.

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