Nursing Elites

1. What should be included in teaching for a patient with pre-dialysis end-stage kidney disease?

• A. Limit phosphorus intake to 700 mg/day
• B. Increase protein intake to 1g/kg/day
• C. Increase sodium intake
• D. Limit sodium to 1,500 mg/day

Correct answer: A

Rationale: The correct answer is to limit phosphorus intake to 700 mg/day for a patient with pre-dialysis end-stage kidney disease. Excessive phosphorus intake can lead to further complications in kidney disease, such as bone and cardiovascular issues. Choice B is incorrect as increasing protein intake can put additional stress on the kidneys due to the buildup of urea and other waste products. Choice C is incorrect because increasing sodium intake can worsen hypertension and fluid retention, common issues in kidney disease. Choice D is incorrect as limiting sodium intake is generally recommended in kidney disease to manage blood pressure and fluid balance.

2. What is the priority lab value to monitor in a patient with HIV?

• A. CD4 T-cell count 180 cells/mm3
• B. White blood cell count 4,500/mm3
• C. Potassium levels 3.5-5.0 mEq/L
• D. Hemoglobin levels below 12g/dL

Correct answer: A

Rationale: The correct answer is A: CD4 T-cell count 180 cells/mm3. Monitoring the CD4 T-cell count is crucial in patients with HIV to assess the status of their immune system. A CD4 count of 180 cells/mm3 indicates severe immunocompromise and a high risk of opportunistic infections. This value is used to guide treatment decisions and assess the need for prophylaxis against specific infections. Choices B, C, and D are incorrect because monitoring white blood cell count, potassium levels, and hemoglobin levels, although important in HIV patients, are not as crucial as monitoring the CD4 T-cell count for assessing immune function and disease progression.

3. A nurse is providing discharge teaching to a client who is starting to take carbidopa/levodopa to treat Parkinson's disease. Which of the following instructions should the nurse include in the teaching?

• A. This medication can cause your urine to turn a dark color.
• B. Expect immediate relief after taking this medication.
• C. Take the medication with a high protein food.
• D. Skip a dose of the medication if you experience dizziness.

Correct answer: A

Rationale: The correct instruction to include in the teaching is that carbidopa/levodopa can cause the client's urine to turn a dark color, which is a harmless effect. It is crucial for the nurse to educate the client about this common side effect. Choice B is incorrect because immediate relief is not expected; therapeutic effects may take weeks to months. Choice C is incorrect as carbidopa/levodopa should be taken on an empty stomach to enhance absorption. Choice D is incorrect as the client should not skip doses without consulting their healthcare provider, even if they experience dizziness.

4. What dietary recommendation should be given to a patient with pre-dialysis end-stage kidney disease?

• A. Limit phosphorus intake to 700 mg/day
• B. Increase sodium intake
• C. Restrict protein intake to 0.55-0.60 g/kg/day
• D. Eat three large meals per day

Correct answer: A

Rationale: The correct dietary recommendation for a patient with pre-dialysis end-stage kidney disease is to limit phosphorus intake to 700 mg/day. Excess phosphorus can be harmful to individuals with kidney disease as their kidneys are not able to remove it effectively. Choice B is incorrect as increasing sodium intake is generally not recommended for individuals with kidney disease due to its association with high blood pressure. Choice C is also incorrect as protein restriction is a common recommendation for patients with advanced kidney disease, but the range provided is not accurate. Choice D is incorrect as eating three large meals per day may not be suitable for managing the condition.

5. A nurse is teaching a group of assistive personnel (AP) about caring for clients who have Alzheimer's disease. Which of the following information should the nurse include in the teaching?

• A. Explain procedures clearly and concisely to the client before initiating care
• B. Encourage a client's engagement in appropriate activities to minimize emotional outbursts
• C. Speak calmly and at a moderate volume to a client who is unable to form words or sentences
• D. Provide supervision to prevent a client from becoming injured or lost

Correct answer: D

Rationale: The correct answer is D because clients with Alzheimer's disease are at risk of wandering and becoming lost. Providing supervision helps prevent them from getting injured or lost. Choice A is incorrect because extensive details may overwhelm clients with Alzheimer's. Choice B is incorrect because limiting activities can lead to boredom and behavioral issues. Choice C is incorrect because speaking calmly and at a moderate volume helps to reduce agitation and confusion in clients with Alzheimer's.

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