Nursing Elites

1. What is the priority for a client with dehydration?

• A. Administer antiemetics to prevent nausea
• B. Monitor electrolyte levels to prevent imbalances
• C. Administer oral rehydration solutions
• D. Administer intravenous fluids

Correct answer: B

Rationale: The priority for a client with dehydration is to monitor electrolyte levels to prevent imbalances. Dehydration can lead to electrolyte disturbances, which can have serious consequences. Administering antiemetics (Choice A) may help with nausea but does not address the root cause of dehydration. Administering oral rehydration solutions (Choice C) can be beneficial, but monitoring electrolyte levels is crucial in managing dehydration. Administering intravenous fluids (Choice D) is important in severe cases of dehydration, but monitoring electrolytes should come first to assess the extent of the imbalance and guide fluid replacement therapy effectively.

2. What is the role of a nurse in managing a patient with kidney disease?

• A. Monitor blood pressure and provide dietary education
• B. Monitor urine output and provide IV fluids
• C. Administer diuretics and restrict fluid intake
• D. Monitor for cardiac arrhythmias and provide dialysis

Correct answer: A

Rationale: The correct answer is A. Nurses play a crucial role in managing patients with kidney disease by monitoring blood pressure and providing essential dietary education. This helps in maintaining kidney function and overall health. Choice B is incorrect because monitoring urine output and providing IV fluids are tasks usually performed by healthcare providers such as physicians or specialized staff. Choice C is incorrect as administering diuretics and restricting fluid intake are typically prescribed by a physician, and nurses may assist in monitoring the effects. Choice D is incorrect as monitoring for cardiac arrhythmias and providing dialysis are tasks that are usually overseen by healthcare providers with specialized training in cardiology and nephrology.

3. A nurse has administered medications to a group of clients. For which of the following client situations should the nurse complete an incident report?

• A. Administering acetaminophen to an NPO client
• B. Administering insulin lispro to an NPO client
• C. Administering medication to the incorrect client
• D. Administering anticoagulants without checking INR

Correct answer: B

Rationale: The correct answer is B because administering insulin lispro to an NPO client can lead to hypoglycemia due to the lack of food to balance the medication. This situation poses a serious risk to the client's safety and should be documented in an incident report. Choice A is not as critical as insulin administration for an NPO client. Choice C is also serious but does not pose an immediate risk to the client's health. Choice D, administering anticoagulants without checking the INR, is important but does not require an incident report unless adverse effects occur, as it may not immediately endanger the client's life.

4. A nurse is receiving change-of-shift report for four clients. Which of the following clients should the nurse see first?

• A. A client with pneumonia who had new onset of confusion
• B. A client with diabetes who had low blood sugar overnight
• C. A client with a leg fracture who needs pain medication
• D. A client whose urinary output was 100 mL for the past 12 hours

Correct answer: A

Rationale: The correct answer is A. New confusion in a client with pneumonia could indicate hypoxia or a worsening condition, requiring immediate attention. Option B, a client with diabetes having low blood sugar overnight, is a concerning condition but not as urgent as potential hypoxia. Option C, a client with a leg fracture needing pain medication, and option D, a client with decreased urinary output, are important but do not take precedence over addressing a potentially critical respiratory issue.

5. 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.

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