Nursing Elites

1. Which of the following interventions is the best to improve the healing of a pressure ulcer for a client with a low serum albumin level?

• A. Provide high-calorie, high-protein supplements
• B. Consult a dietitian to create a high-protein diet plan
• C. Administer nutritional supplements
• D. Increase IV fluids to prevent dehydration

Correct answer: B

Rationale: Consulting a dietitian to create a high-protein diet plan is the best intervention for a client with a low serum albumin level to promote healing. This approach ensures that the client receives the specific nutrients needed for wound healing. Providing high-calorie, high-protein supplements (choice A) may not address the specific nutritional deficiencies of the client. Administering nutritional supplements (choice C) is vague and may not target the necessary nutrients for wound healing. Increasing IV fluids (choice D) is important for hydration but does not directly address the nutritional needs of the client to improve ulcer healing.

2. What are the key signs of hyperkalemia and how should it be treated?

• A. Elevated potassium levels, muscle weakness; administer calcium gluconate
• B. Decreased potassium levels, confusion; administer potassium chloride
• C. Elevated sodium levels, bradycardia; administer sodium bicarbonate
• D. Low sodium levels, muscle cramps; administer sodium chloride

Correct answer: A

Rationale: The correct signs of hyperkalemia include elevated potassium levels and muscle weakness. The treatment involves administering calcium gluconate to help stabilize the heart. Choice B is incorrect as hyperkalemia is characterized by elevated, not decreased, potassium levels. Choice C is incorrect as hyperkalemia does not involve elevated sodium levels, and the treatment is not sodium bicarbonate. Choice D is incorrect as hyperkalemia does not lead to low sodium levels, and sodium chloride is not the treatment for hyperkalemia.

3. A nurse is reinforcing discharge teaching about car seat safety with the guardian of a newborn. Which of the following statements by the guardian indicates an understanding of the teaching?

• A. I will position the car seat in the front seat
• B. I will secure the car seat in the car by using the seatbelt
• C. I will use a rear-facing car seat
• D. I will install the car seat facing forward

Correct answer: C

Rationale: The correct answer is C. Using a rear-facing car seat is the safest position for a newborn. Newborns should always be placed in a rear-facing car seat in the back seat of the vehicle to provide optimal safety in case of a crash. Choice A is incorrect because placing the car seat in the front seat is not safe due to the presence of airbags. Choice B is incorrect as securing the car seat using the seatbelt is not specific to the correct positioning of the car seat. Choice D is incorrect because installing the car seat facing forward is not recommended for newborns as it does not provide the same level of protection as a rear-facing position.

4. Which of the following is a key consideration when caring for a client with heart failure on fluid restriction?

• A. Encourage the client to drink more fluids to stay hydrated
• B. Weigh the client daily to monitor fluid status
• C. Limit the client's intake of fruits and vegetables
• D. Monitor the client's fluid intake only during meals

Correct answer: B

Rationale: When caring for a client with heart failure on fluid restriction, weighing the client daily is crucial to monitor fluid balance accurately. This helps healthcare providers assess if the client is retaining excess fluids, which can worsen heart failure. Encouraging the client to drink more fluids (choice A) contradicts the goal of fluid restriction. Limiting intake of fruits and vegetables (choice C) is not a specific guideline for managing fluid restriction in heart failure. Monitoring fluid intake only during meals (choice D) is insufficient as fluid balance needs to be monitored consistently throughout the day.

5. A healthcare professional is reviewing the medical history of a client with dementia. Which of the following findings should be addressed immediately?

• A. Frequent episodes of wandering at night
• B. Restlessness and agitation
• C. Mild confusion during the day
• D. Incontinence

Correct answer: B

Rationale: Restlessness and agitation in clients with dementia should be addressed immediately as they can indicate underlying causes such as pain, discomfort, or unmet needs. Addressing these symptoms promptly can help prevent the escalation of behavioral issues and improve the client's quality of life. While frequent episodes of wandering at night, mild confusion during the day, and incontinence are also important issues to address in clients with dementia, restlessness and agitation usually require immediate attention to ensure the safety and well-being of the client.

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