Nursing Elites

1. What should be included in dietary teaching for a client with chronic kidney disease?

• A. Increase potassium-rich foods in the diet
• B. Limit potassium and phosphorus intake
• C. Increase intake of protein-rich foods
• D. Increase fluid intake to prevent dehydration

Correct answer: B

Rationale: The correct answer is to limit potassium and phosphorus intake for a client with chronic kidney disease. Excessive potassium and phosphorus can be harmful to individuals with compromised kidney function. Option A is incorrect because increasing potassium-rich foods can exacerbate hyperkalemia in individuals with kidney disease. Option C may not be ideal as excessive protein intake can put extra strain on the kidneys. Option D is not the priority; while adequate fluid intake is important, it is not the primary focus when teaching dietary considerations for chronic kidney disease.

2. What is the priority nursing action for a patient with an acute asthma attack?

• A. Administer a bronchodilator
• B. Monitor oxygen saturation
• C. Position the patient in a high Fowler's position
• D. Call for assistance

Correct answer: A

Rationale: The correct answer is to administer a bronchodilator. During an acute asthma attack, the priority is to open the airways and improve breathing. Bronchodilators are the first-line treatment for asthma attacks as they help dilate the bronchioles, allowing for better airflow. Monitoring oxygen saturation is important but not the priority when the patient is in distress. Placing the patient in a high Fowler's position can help with breathing but is not the initial priority. Calling for assistance can be done after initiating the appropriate treatment.

3. What is the primary action the nurse should take first for a client with a pressure ulcer who has a serum albumin level of 3 g/dL?

• A. Increase the protein intake in the diet
• B. Consult with a dietitian to create a high-protein diet
• C. Increase the IV fluid infusion rate
• D. Administer a protein supplement

Correct answer: B

Rationale: The correct answer is to consult with a dietitian to create a high-protein diet. A serum albumin level of 3 g/dL indicates hypoalbuminemia, which can impair wound healing. Consulting with a dietitian to optimize the client's protein intake is crucial in promoting wound healing for pressure ulcers. Increasing the protein intake in the diet (Choice A) may not be sufficient without proper guidance from a dietitian. Increasing the IV fluid infusion rate (Choice C) is not directly related to addressing the protein deficiency. Administering a protein supplement (Choice D) should be guided by a healthcare professional's recommendation after consulting with a dietitian.

4. A nurse is providing discharge instructions for a client using home oxygen. What is the most important safety measure?

• A. Store oxygen tanks in a closet when not in use
• B. Ensure that oxygen tanks are kept upright and away from heat sources
• C. Allow family members to smoke in designated areas
• D. Restrict fluid intake while using oxygen

Correct answer: B

Rationale: The correct answer is B: Ensure that oxygen tanks are kept upright and away from heat sources. This is the most important safety measure to prevent accidents related to home oxygen use. Storing oxygen tanks in a closet when not in use (choice A) is not recommended as they should be stored in a well-ventilated area. Allowing family members to smoke in designated areas (choice C) poses a significant fire hazard. Restricting fluid intake while using oxygen (choice D) is not a safety measure related to oxygen use.

5. A client with chronic obstructive pulmonary disease (COPD) is being taught by a nurse about measures to improve breathing. Which of the following instructions should the nurse include?

• A. Use pursed-lip breathing during physical activity
• B. Breathe deeply and quickly during exercise
• C. Avoid using the incentive spirometer
• D. Avoid physical activity to conserve energy

Correct answer: A

Rationale: The correct instruction the nurse should include is to 'Use pursed-lip breathing during physical activity.' Pursed-lip breathing is a technique that helps improve breathing efficiency in individuals with COPD by preventing airway collapse and allowing for better air exchange. Choice B is incorrect because breathing deeply and quickly can lead to hyperventilation and worsen symptoms in COPD patients. Choice C is incorrect because the incentive spirometer is a device used to encourage deep breathing and improve lung function, so it should not be avoided. Choice D is incorrect because physical activity is important for maintaining overall health and should be encouraged in a controlled and appropriate manner for individuals with COPD.

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