Nursing Elites

1. Which dietary advice is most appropriate for a client with chronic kidney disease?

• A. Increase intake of fruits and vegetables
• B. Limit intake of potassium-rich foods
• C. Increase intake of dairy products
• D. Reduce intake of protein-rich foods

Correct answer: B

Rationale: The most appropriate dietary advice for a client with chronic kidney disease is to limit intake of potassium-rich foods. In chronic kidney disease, the kidneys have difficulty filtering potassium from the blood, leading to high levels that can be harmful. Therefore, reducing potassium intake is crucial to prevent complications. Choices A, C, and D are not the best options for individuals with chronic kidney disease. Increasing intake of fruits and vegetables (choice A) may actually increase potassium consumption. Increasing intake of dairy products (choice C) can lead to higher phosphorus and potassium levels. Reducing protein-rich foods (choice D) is not the primary focus in the early stages of chronic kidney disease, as protein is necessary for overall health unless kidney function declines significantly.

2. A client has a prescription for ciprofloxacin. Which of the following instructions should the nurse include?

• A. Take the medication with an antacid if you experience gastrointestinal upset.
• B. You should limit your caffeine intake while taking this medication.
• C. This medication may cause your urine to turn dark brown.
• D. You should avoid taking this medication with dairy products.

Correct answer: D

Rationale: The correct answer is D: 'You should avoid taking this medication with dairy products.' Ciprofloxacin should not be taken with dairy products as they can interfere with the absorption of the medication. Choice A is incorrect because ciprofloxacin should not be taken with antacids containing aluminum or magnesium. Choice B is incorrect as there is no specific limitation on caffeine intake associated with ciprofloxacin. Choice C is incorrect as ciprofloxacin does not typically cause urine to turn dark brown.

3. A client is constipated and asks the nurse for advice. What should the nurse recommend?

• A. Administer a laxative to relieve discomfort
• B. Increase dietary fiber to promote bowel movements
• C. Advise the client to rest until symptoms resolve
• D. Encourage bed rest to allow bowel function to return

Correct answer: B

Rationale: The correct recommendation for constipation is to increase dietary fiber to promote bowel movements. Dietary fiber helps add bulk to the stool, making it easier to pass and promoting regular bowel movements. Administering a laxative (Choice A) is not the first-line recommendation and should be used cautiously due to potential side effects. Resting until symptoms resolve (Choice C) and encouraging bed rest (Choice D) are not effective interventions for relieving constipation.

4. A client at 20 weeks of gestation is being taught by a nurse about an alpha-fetoprotein (AFP) test. Which of the following information should the nurse include?

• A. This test is used to confirm pregnancy
• B. This test is used to detect neural tube defects
• C. This test will determine the baby's lung maturity
• D. This test will check for gestational diabetes

Correct answer: B

Rationale: The correct answer is B: 'This test is used to detect neural tube defects.' An alpha-fetoprotein test is essential for screening neural tube defects in the fetus, not for confirming pregnancy, determining lung maturity, or checking for gestational diabetes. Detecting neural tube defects is crucial for early intervention and management of potential health issues in the baby.

5. A nurse is caring for a client who is receiving total parenteral nutrition (TPN). Which of the following actions should the nurse take?

• A. Administer the TPN through a peripheral IV catheter.
• B. Check the client's capillary blood glucose level every 4 hours.
• C. Heat the TPN solution to room temperature before administering.
• D. Weigh the client every 3 days.

Correct answer: B

Rationale: The correct answer is to check the client's capillary blood glucose level every 4 hours. Clients receiving TPN are at risk for hyperglycemia, so regular monitoring of blood glucose levels is essential to detect and manage hyperglycemia promptly. Administering TPN through a peripheral IV catheter (Choice A) is incorrect as TPN should be given through a central venous catheter to prevent complications. Heating the TPN solution to room temperature (Choice C) is unnecessary and not a standard practice. Weighing the client every 3 days (Choice D) is important for monitoring fluid status but is not the priority action when caring for a client receiving TPN.

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