Nursing Elites

1. What is the most appropriate response when a client with chronic kidney disease asks about fluid restrictions?

• A. Fluid restrictions are not needed for all clients with chronic kidney disease.
• B. You may need to limit fluid intake to prevent fluid overload.
• C. Fluid restrictions are based on your lab results and daily weights.
• D. Restricting fluids is only necessary during dialysis.

Correct answer: B

Rationale: The most appropriate response when a client with chronic kidney disease asks about fluid restrictions is to inform them that limiting fluid intake may be necessary to prevent fluid overload. This is crucial in managing the condition and preventing complications such as edema and electrolyte imbalances. Choice A is incorrect as fluid restrictions are commonly advised for clients with chronic kidney disease. Choice C is partially correct as fluid restrictions are indeed based on lab results and daily weights, but the primary goal is to prevent fluid overload. Choice D is incorrect because fluid restrictions are not limited to just during dialysis; they are often recommended throughout the day to manage the condition.

2. A client with a new prescription for prednisone for the treatment of Addison's disease needs teaching. Which instruction should the nurse include?

• A. Take the medication with food
• B. Avoid taking aspirin
• C. Schedule a bone density test
• D. Expect increased appetite

Correct answer: C

Rationale: The correct instruction for the nurse to include is to schedule a bone density test. Prednisone can lead to reduced bone density, making regular monitoring crucial for clients on long-term therapy. Instructing the client to take the medication with food (choice A) or avoid taking aspirin (choice B) are not directly related to prednisone therapy for Addison's disease. While prednisone can cause increased appetite, it is not the priority instruction in this scenario, compared to monitoring bone density (choice D).

3. A nurse is caring for a client who is 2 days postoperative following abdominal surgery and has a new prescription for a regular diet. For which of the following findings should the nurse notify the provider?

• A. Presence of bowel sounds
• B. Client reports nausea
• C. Client is vomiting
• D. Absent bowel sounds

Correct answer: D

Rationale: The correct answer is D. Absent bowel sounds are concerning as they indicate potential complications such as ileus, which is a risk after abdominal surgery. The absence of bowel sounds can suggest decreased or absent intestinal motility, which may lead to complications if not addressed promptly. The nurse should notify the provider immediately to assess the situation and intervene accordingly. Choices A and B are common postoperative occurrences and do not necessarily warrant immediate provider notification. Choice C, vomiting, while concerning, may be a common postoperative symptom; however, absent bowel sounds are a more critical finding that requires prompt attention.

4. A nurse is performing vision testing for a client following a head injury. Which of the following findings should the nurse identify as a problem with pupil accommodation?

• A. Pupils constrict when shifting gaze from near to far
• B. Pupils constrict when shifting gaze from far to near
• C. Lack of change in pupil size when shifting gaze from near to far
• D. Lack of change in pupil size when shifting gaze from far to near

Correct answer: D

Rationale: Pupil accommodation problems are indicated by the lack of change in size when shifting gaze from far to near. The correct answer is D because in pupil accommodation, the pupils should constrict when shifting gaze from far to near in order to adjust for near vision. Choices A and B describe normal responses of pupil constriction when shifting gaze, which do not indicate a problem. Choice C is incorrect as it describes a normal response of pupil size change when shifting gaze from near to far.

5. A client who is taking furosemide is being taught by a nurse about dietary modifications. Which of the following foods should the nurse recommend to the client?

• A. Bananas
• B. Cabbage
• C. Potatoes
• D. Carrots

Correct answer: A

Rationale: The correct answer is A, Bananas. Bananas are high in potassium, which is essential for clients taking furosemide to prevent hypokalemia. Furosemide is a diuretic that can cause potassium loss through increased urine output. Therefore, recommending foods rich in potassium, such as bananas, can help maintain potassium levels within the normal range. Choices B, C, and D are not the best recommendations in this case as they are not particularly high in potassium.

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