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 first-line treatment for a patient experiencing wheezing and coughing due to an allergic reaction?

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

Correct answer: A

Rationale: The correct answer is A: Albuterol via nebulizer. Albuterol is the first-line treatment for wheezing caused by an allergic reaction as it quickly opens the airways, providing rapid relief. Choice B, Methylprednisolone 100 mg IV, is a systemic corticosteroid that may be used in severe cases to reduce inflammation but is not the initial treatment for acute wheezing. Choice C, Cromolyn 20 mg via nebulizer, is a mast cell stabilizer that is more commonly used for prophylaxis rather than acute relief in allergic conditions. Choice D, Aminophylline 500 mg IV, is a bronchodilator that is less commonly used now due to its narrow therapeutic window and potential for toxicity, making it less preferred than Albuterol for initial treatment of wheezing.

3. What should a healthcare professional monitor in a patient receiving insulin who is at risk for hypoglycemia?

• A. Monitor blood glucose levels
• B. Monitor for respiratory distress
• C. Monitor for muscle weakness
• D. Monitor for hyperkalemia

Correct answer: A

Rationale: Monitoring blood glucose levels is crucial in patients receiving insulin who are at risk for hypoglycemia. Insulin can lower blood sugar levels, potentially leading to hypoglycemia, which can be harmful if not promptly recognized and managed. Checking blood glucose levels allows for early detection of low blood sugar levels, enabling timely interventions to prevent complications. Choices B, C, and D are incorrect as they do not directly relate to monitoring for hypoglycemia in patients receiving insulin.

4. 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.

5. What is the primary concern in a patient with a low CD4 T-cell count in HIV?

• A. Increased risk of infection
• B. Increased risk of bleeding
• C. Decreased immunity leading to opportunistic infections
• D. Increased risk of cardiac complications

Correct answer: A

Rationale: The correct answer is A: Increased risk of infection. In HIV patients with a low CD4 T-cell count, the primary concern is the increased susceptibility to infections due to compromised immunity. This compromised immune system can lead to various infections, making infection control crucial. Choice B, increased risk of bleeding, is not directly associated with a low CD4 count in HIV. Option C, decreased immunity leading to opportunistic infections, conveys a similar concern as the correct answer but lacks specificity. Choice D, increased risk of cardiac complications, is not typically the primary concern in HIV patients with a low CD4 count, as infections and opportunistic diseases pose more immediate threats to health.

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