Nursing Elites

1. What teaching should be provided to a patient following surgical removal of a cataract?

• A. Avoid NSAIDs
• B. Wear dark glasses while outdoors
• C. Creamy white drainage is normal
• D. Reduce phosphorus intake to 700 mg/day

Correct answer: A

Rationale: The correct teaching to provide to a patient following surgical removal of a cataract is to avoid NSAIDs. NSAIDs can increase the risk of bleeding at the surgical site, so it is important to steer clear of them. Choice B, wearing dark glasses while outdoors, may be recommended post-surgery to protect the eyes from bright light, but it is not the priority teaching in this case. Choice C, stating that creamy white drainage is normal, is not accurate as drainage from the eye should be monitored and reported. Choice D, reducing phosphorus intake to 700 mg/day, is unrelated to post-cataract surgery care and is not a necessary teaching point.

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. While administering a blood transfusion, a nurse suspects that the client is having an adverse reaction. Which of the following actions should the nurse take first?

• A. Maintain IV access
• B. Obtain the client's vital signs
• C. Contact the provider
• D. Stop the transfusion

Correct answer: D

Rationale: The correct first action for the nurse to take when suspecting an adverse reaction to a blood transfusion is to stop the transfusion immediately. Stopping the transfusion helps prevent further harm to the client. Maintaining IV access and obtaining vital signs are important steps but come after stopping the transfusion in this situation. Contacting the provider can be done after ensuring the client's safety by stopping the transfusion.

4. A patient with GERD is receiving dietary teaching from a nurse. What should the nurse recommend?

• A. Avoid mint and pepper
• B. Increase fluid intake before meals
• C. Eat three large meals per day
• D. Avoid drinking water with meals

Correct answer: A

Rationale: The correct recommendation for a patient with GERD is to avoid foods like mint and pepper, as these can help reduce gastric acid secretion and alleviate symptoms. Mint and pepper are known to relax the lower esophageal sphincter, leading to increased reflux. Increasing fluid intake before meals (choice B) may worsen GERD symptoms by distending the stomach. Eating three large meals per day (choice C) can also aggravate GERD because large meals can lead to increased gastric pressure and reflux. Avoiding drinking water with meals (choice D) is generally recommended for GERD; however, the most crucial advice in this case is to avoid mint and pepper for better symptom management.

5. What dietary recommendations should a patient with GERD follow?

• A. Avoid mint and spicy foods
• B. Consume liquids between meals
• C. Eat three large meals per day
• D. Drink milk as a snack

Correct answer: A

Rationale: Patients with GERD should follow dietary recommendations to manage their symptoms effectively. Choice A, 'Avoid mint and spicy foods,' is the correct answer. Mint and spicy foods can trigger acid reflux and worsen GERD symptoms. Choice B, 'Consume liquids between meals,' is not the best recommendation as consuming liquids during meals can worsen GERD symptoms by increasing stomach pressure. Choice C, 'Eat three large meals per day,' is incorrect as large meals can exacerbate GERD symptoms; instead, smaller, more frequent meals are recommended. Choice D, 'Drink milk as a snack,' is not ideal as full-fat dairy products like milk can trigger acid reflux in some individuals. Therefore, the best recommendation for a patient with GERD is to avoid mint and spicy foods.

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