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 intervention is needed when continuous bubbling is observed in the chest tube water seal chamber?

• A. Tighten the connections of the chest tube system
• B. Clamp the chest tube
• C. Replace the chest tube system
• D. Continue monitoring the chest tube

Correct answer: A

Rationale: When continuous bubbling is observed in the chest tube water seal chamber, the correct intervention is to tighten the connections of the chest tube system. This can help resolve an air leak that is causing the continuous bubbling. Clamping the chest tube or replacing the entire chest tube system are not appropriate interventions in this scenario. Clamping the tube can lead to a dangerous buildup of pressure, while replacing the chest tube system may not be necessary if the issue can be resolved by simply tightening the connections. Continuing to monitor the chest tube without taking corrective action may lead to complications associated with the air leak.

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 should the nurse do when continuous bubbling is seen in the chest tube water seal chamber?

• A. Tighten the connections of the chest tube system
• B. Clamp the chest tube
• C. Replace the chest tube
• D. Continue monitoring the chest tube

Correct answer: A

Rationale: When continuous bubbling is observed in the chest tube water seal chamber, the nurse should tighten the connections of the chest tube system. This action can often resolve an air leak causing the continuous bubbling. Clamping the chest tube or replacing it would not address the underlying issue of an air leak and may lead to complications. Continuing to monitor the chest tube without taking corrective action may result in the deterioration of the patient's condition.

5. A nurse at a provider's office is interviewing a client who has multiple sclerosis and has been taking dantrolene for several months. Which of the following client statements should the nurse identify as an indication that the medication is effective?

• A. I don't have muscle spasms as frequently.
• B. I haven't gotten any colds, even though it is flu season.
• C. I feel like my nerve pain has improved.
• D. It is easier to urinate now.

Correct answer: A

Rationale: The correct answer is A: 'I don't have muscle spasms as frequently.' Dantrolene is a medication that relaxes skeletal muscles and is commonly prescribed to treat muscle spasms in clients with multiple sclerosis. Therefore, a reduction in muscle spasms frequency would be an indication of the medication's effectiveness. Choices B, C, and D are incorrect because dantrolene is not indicated for preventing colds, improving nerve pain, or easing urination. The focus should be on the medication's intended purpose, which is to address muscle spasms in clients with multiple sclerosis.

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