Nursing Elites

1. Which of the following dietary modifications should be recommended for a patient with chronic kidney disease (CKD)?

• A. High protein, low sodium
• B. Low protein, high potassium
• C. Low sodium, low potassium
• D. High calcium, low phosphorus

Correct answer: C

Rationale: A low sodium, low potassium diet is often recommended for patients with CKD to manage fluid balance and prevent electrolyte imbalances that the kidneys can no longer regulate effectively. High protein diets, as mentioned in choice A, can put extra strain on the kidneys, making it an incorrect choice. Choice B, which suggests a low protein, high potassium diet, is also incorrect because high potassium levels can be harmful to individuals with CKD. Choice D, advocating for a high calcium, low phosphorus diet, is not the typical dietary recommendation for CKD patients, even though managing calcium and phosphorus levels is important in their diet.

2. The PN observes a UAP bathing a bedfast client with the bed in the high position. Which action should the PN take?

• A. Remain in the room to supervise the UAP
• B. Determine if the UAP would like assistance
• C. Assume care of the client immediately
• D. Instruct the UAP to lower the bed for safety

Correct answer: D

Rationale: The correct action for the PN to take in this situation is to instruct the UAP to lower the bed for safety. Keeping the bed in the lowest position during care activities is crucial for preventing falls and injuries to both the client and the caregiver. Instructing the UAP to lower the bed addresses the immediate safety concern. Choice A is incorrect because simply supervising the UAP without addressing the unsafe bed height does not ensure the client's safety. Choice B is incorrect as the priority is to address the safety concern rather than offering assistance to the UAP. Choice C is incorrect as assuming care of the client immediately does not address the root issue of the high bed position.

3. At the end of a 12-hour shift, the PN observes the urine in a client's drainage bag as seen in the picture. Which action should the PN take next?

• A. Offer to administer a prescribed PRN analgesic
• B. Obtain a finger stick capillary glucose level
• C. Determine if the client's bladder feels distended
• D. Note the most recent white blood cell count

Correct answer: D

Rationale: Noting the white blood cell count is the most appropriate action in this situation. Changes in urine appearance could indicate infection, and assessing the white blood cell count helps in evaluating the possibility of infection. This is crucial for understanding the client's overall condition. The other options are not directly related to assessing infection based on urine appearance. Offering analgesics, checking glucose levels, or determining bladder distention may not address the underlying issue of a potential infection.

4. What is an essential nursing action before administering a blood transfusion?

• A. Checking the patient’s blood pressure
• B. Verifying the blood type and patient identity with another nurse
• C. Flushing the IV line with saline
• D. Administering pre-transfusion medications

Correct answer: B

Rationale: Verifying the blood type and patient identity with another nurse is crucial before administering a blood transfusion. This step helps prevent transfusion reactions and ensures that the correct blood is given to the right patient. Checking the patient’s blood pressure, although important, is not directly related to verifying blood type and patient identity. Flushing the IV line with saline is a good practice but is not as critical as confirming the blood type and patient identity. Administering pre-transfusion medications would come after verifying the blood type and patient identity.

5. Which hormone is primarily responsible for the regulation of calcium and phosphate in the blood?

• A. Parathyroid hormone
• B. Insulin
• C. Cortisol
• D. Thyroxine

Correct answer: A

Rationale: Parathyroid hormone is the correct answer. It regulates calcium and phosphate levels in the blood by increasing calcium reabsorption in the kidneys and releasing calcium from bones. Insulin is involved in glucose metabolism, not calcium and phosphate regulation. Cortisol is a stress hormone and is not primarily responsible for regulating calcium and phosphate levels. Thyroxine is a thyroid hormone that primarily regulates metabolism, not calcium and phosphate in the blood.

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