Nursing Elites

1. What dietary recommendations should be given to a patient with GERD?

• A. Avoid mint and spicy foods
• B. Eat large meals before bed
• C. Increase fluid intake during meals
• D. Drink milk as a snack

Correct answer: A

Rationale: The correct dietary recommendation for a patient with GERD is to avoid mint and spicy foods. These foods can trigger symptoms of GERD and lead to acid reflux. Choice B is incorrect because eating large meals before bed can exacerbate GERD symptoms by increasing the likelihood of acid reflux during sleep. Choice C is incorrect as increasing fluid intake during meals can worsen GERD symptoms by distending the stomach, leading to increased pressure on the lower esophageal sphincter. Choice D is also incorrect because while milk may provide temporary relief for some individuals, it is not a recommended long-term solution for managing GERD.

2. What is the expected finding in a patient with compartment syndrome?

• A. Unrelieved pain, pallor, and pulselessness
• B. Localized swelling and redness
• C. Numbness and tingling
• D. Fever and infection

Correct answer: A

Rationale: In a patient with compartment syndrome, the expected finding includes unrelieved pain, pallor, and pulselessness. These are classic signs of compartment syndrome and indicate compromised blood flow and tissue perfusion, necessitating urgent intervention. Choices B, C, and D are incorrect because localized swelling and redness, numbness and tingling, as well as fever and infection, are not typical findings associated with compartment syndrome.

3. What is the first medication to give for wheezing due to an allergic reaction?

• A. Albuterol via nebulizer
• B. Cromolyn 20 mg via nebulizer
• C. Methylprednisolone 100 mg IV
• D. Aminophylline 500 mg IV

Correct answer: A

Rationale: Albuterol is the first-line medication for treating wheezing due to an allergic reaction. Albuterol is a short-acting beta-agonist that helps relieve bronchospasm quickly. Cromolyn is more commonly used for the prevention of asthma symptoms rather than for acute treatment. Methylprednisolone and aminophylline are not the first-line medications for acute wheezing due to an allergic reaction.

4. 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.

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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