Nursing Elites

1. Which of the following statements about chest X-rays is false?

• A. There are contraindications for this test
• B. Before the procedure, the patient should remove all jewelry, metallic objects, and buttons above the waist
• C. A signed consent is not required
• D. Eating, drinking, and medications are allowed before this test

Correct answer: A

Rationale: The correct answer is A because there are contraindications for chest X-rays, such as pregnancy or concerns about radiation exposure. Patients may need to remove jewelry and metallic objects to prevent interference with the imaging. While a signed consent is typically not required for a routine chest X-ray, there are specific situations where consent may be necessary. It is essential for patients to follow fasting instructions before certain types of chest X-rays to obtain accurate results.

2. A client has chronic pancreatitis. Which of the following dietary recommendations should be made?

• A. Coffee with creamer
• B. Lettuce with sliced avocados
• C. Broiled skinless chicken breast with brown rice
• D. None of the above

Correct answer: C

Rationale: Chronic pancreatitis requires a low-fat diet to reduce stress on the pancreas. Broiled skinless chicken breast with brown rice is a suitable option as it is low in fat. Coffee with creamer and lettuce with sliced avocados are not recommended for individuals with chronic pancreatitis due to their fat content. Choosing options high in fat can exacerbate symptoms and increase the workload on the pancreas, worsening the condition.

3. A nurse is orienting a newly licensed nurse on performing a routine assessment of a client who is receiving mechanical ventilation via an endotracheal tube. Which of the following information should the nurse include in the teaching?

• A. Apply a vest restraint if self-extubation is attempted.
• B. Monitor ventilator settings every 8 hours.
• C. Document tube placement in centimeters at the angle of the jaw.
• D. Assess breath sounds every 1 to 2 hours.

Correct answer: D

Rationale: Assessing breath sounds every 1 to 2 hours is crucial in monitoring the client's respiratory status and identifying any potential complications promptly. Monitoring ventilator settings every 8 hours is important for overall ventilation management. Documenting the endotracheal tube placement accurately is essential to ensure proper positioning. Using a vest restraint if self-extubation is attempted is not a recommended intervention as it can lead to complications and should be avoided.

4. During a seizure, what is the primary intervention?

• A. Protect the patient from injury
• B. Insert an airway
• C. Elevate the head of the bed
• D. Withdraw all pain medications

Correct answer: A

Rationale: The primary intervention during a seizure is to protect the patient from injury. This involves creating a safe environment by moving harmful objects away, cushioning the head, and staying with the patient until the seizure ends. Inserting an airway is only necessary if the patient's airway is obstructed, not routinely during a seizure. Elevating the head of the bed is not a priority during an active seizure as it won't affect the seizure's outcome. Withdrawing all pain medications is not a standard practice unless there are specific contraindications related to the seizure itself.

5. When providing discharge teaching for a group of clients, a nurse should recommend a referral to a dietitian for which client?

• A. A client who has a prescription for warfarin and states, 'I will need to limit how much spinach I eat.'
• B. A client who has gout and states, 'I can continue to eat anchovies on my pizza.'
• C. A client who has a prescription for spironolactone and states, 'I will reduce my intake of foods that contain potassium.'
• D. A client who has osteoporosis and states, 'I'll plan to take my calcium carbonate with a full glass of water.'

Correct answer: B

Rationale: The correct answer is the client who has gout and states, 'I can continue to eat anchovies on my pizza.' Gout is a condition that requires dietary modifications to manage symptoms. Anchovies are high in purines, which can exacerbate gout symptoms. Therefore, a referral to a dietitian is essential to provide appropriate dietary guidance for a client with gout. Clients on warfarin may need to monitor their vitamin K intake, particularly from foods like spinach. Clients taking spironolactone should be cautious about potassium-rich foods. Clients with osteoporosis should be educated on the proper administration of calcium supplements but do not necessarily need a dietitian referral for this specific statement.

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