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 phosphorus and potassium intake
• C. Encourage protein-rich foods to improve nutrition
• D. Increase calcium-rich foods in the diet

Correct answer: B

Rationale: The correct answer is to limit phosphorus and potassium intake for a client with chronic kidney disease. In renal insufficiency, the kidneys struggle to excrete these minerals, leading to their buildup in the blood, which can be harmful. Limiting phosphorus and potassium intake helps prevent further kidney damage and manage the progression of chronic kidney disease. Encouraging protein-rich foods (Choice C) may be counterproductive as excessive protein intake can burden the kidneys. Increasing potassium-rich foods (Choice A) is incorrect as high potassium levels can be detrimental in kidney disease. Increasing calcium-rich foods (Choice D) is not typically a focus in dietary teaching for chronic kidney disease unless there is a specific deficiency or need, as excessive calcium intake can also be harmful to kidney function.

2. A nurse is reviewing the record of a client with dementia. Which of the following findings should the nurse prioritize?

• A. Wandering at night
• B. A serum albumin level of 3.5 g/dL
• C. Urinary incontinence
• D. Restlessness and agitation

Correct answer: D

Rationale: Restlessness and agitation in clients with dementia could indicate a worsening condition and should be prioritized. While wandering at night and urinary incontinence are common issues in dementia patients, restlessness and agitation can signal acute distress or an unmet need, requiring immediate attention. Monitoring serum albumin levels is important for overall health but would not be the priority when assessing a client with dementia.

3. What is the priority nursing intervention for a patient with chest pain?

• A. Administer nitroglycerin
• B. Assess pain level
• C. Monitor vital signs
• D. Provide oxygen therapy

Correct answer: A

Rationale: The correct answer is to administer nitroglycerin. Nitroglycerin is the priority intervention for a patient with chest pain because it helps relieve chest pain by dilating coronary arteries, improving blood flow to the heart muscle. Assessing pain level, monitoring vital signs, and providing oxygen therapy are important interventions as well, but administering nitroglycerin takes precedence in addressing the immediate symptom of chest pain and potential cardiac ischemia.

4. What is the most appropriate next step when a client with an NG tube attached to low suctioning becomes nauseated, and the nurse observes a decrease in the flow of gastric secretions?

• A. Increase the suction pressure
• B. Irrigate the NG tube with sterile water
• C. Turn the client on their side
• D. Replace the NG tube with a new one

Correct answer: B

Rationale: The correct answer is to irrigate the NG tube with sterile water. When a client with an NG tube attached to low suctioning becomes nauseated and there is a decrease in the flow of gastric secretions, it indicates a possible blockage in the tube. Irrigating the tube with sterile water can help clear the blockage, allowing for proper suctioning and relieving the client's nausea. Increasing the suction pressure (Choice A) can further worsen the issue by potentially causing harm to the client. Turning the client on their side (Choice C) may not address the underlying problem of tube blockage. Replacing the NG tube with a new one (Choice D) should only be considered if other interventions, like irrigation, fail to clear the blockage.

5. Which of the following interventions is most appropriate for a client with a pressure ulcer who has a low albumin level?

• A. Increase protein intake to improve healing
• B. Consult with a dietitian to create a high-protein diet
• C. Provide nutritional supplements
• D. Increase IV fluid intake to improve hydration

Correct answer: B

Rationale: Consulting with a dietitian to create a high-protein diet is the most appropriate intervention for a client with a pressure ulcer and low albumin level. This intervention can help address the client's poor nutritional status, support wound healing, and specifically target the low albumin level. Increasing protein intake alone (Choice A) may not be sufficient without proper guidance. Providing nutritional supplements (Choice C) can be beneficial but consulting with a dietitian for a personalized plan is more effective in this case. Increasing IV fluid intake (Choice D) primarily targets hydration and may not directly address the underlying issue of low albumin and poor nutritional status.

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