Nursing Elites

1. A client with a serum albumin level of 3 g/dL has a pressure ulcer. What should the nurse do first?

• A. Monitor the client's fluid and electrolyte balance
• B. Consult a dietitian to improve the client's nutritional status
• C. Administer a protein supplement
• D. Administer an anti-inflammatory medication

Correct answer: B

Rationale: The correct first action for a client with a serum albumin level of 3 g/dL and a pressure ulcer is to consult a dietitian to improve the client's nutritional status. Adequate nutrition is essential for wound healing. Monitoring fluid and electrolyte balance is important but not the first priority in this situation. Administering a protein supplement can be considered after dietary evaluation. Administering an anti-inflammatory medication is not the primary intervention for addressing a pressure ulcer related to low albumin levels.

2. What are the nursing interventions for a patient with hypertension?

• A. Monitor blood pressure and educate the patient about lifestyle changes
• B. Administer antihypertensive medications and provide dietary education
• C. Provide regular monitoring of blood pressure and administer diuretics
• D. Provide regular blood glucose monitoring

Correct answer: A

Rationale: The correct nursing interventions for a patient with hypertension involve monitoring blood pressure and educating the patient about lifestyle changes. These interventions help in managing hypertension by keeping track of the patient's blood pressure readings and empowering them with knowledge to make lifestyle modifications such as adopting a healthy diet, regular exercise, stress management, and avoiding smoking and excessive alcohol consumption. Administering antihypertensive medications (choice B) is typically done by a healthcare provider rather than a nurse. While regular monitoring of blood pressure (choice C) is important, administering diuretics is a specific medical intervention that should be prescribed by a healthcare provider. Monitoring blood glucose (choice D) is more relevant for patients with diabetes rather than hypertension.

3. What is the most appropriate response when a client with chronic kidney disease asks about fluid restrictions?

• A. Fluid restrictions are not needed for all clients with chronic kidney disease.
• B. You may need to limit fluid intake to prevent fluid overload.
• C. Fluid restrictions are based on your lab results and daily weights.
• D. Restricting fluids is only necessary during dialysis.

Correct answer: B

Rationale: The most appropriate response when a client with chronic kidney disease asks about fluid restrictions is to inform them that limiting fluid intake may be necessary to prevent fluid overload. This is crucial in managing the condition and preventing complications such as edema and electrolyte imbalances. Choice A is incorrect as fluid restrictions are commonly advised for clients with chronic kidney disease. Choice C is partially correct as fluid restrictions are indeed based on lab results and daily weights, but the primary goal is to prevent fluid overload. Choice D is incorrect because fluid restrictions are not limited to just during dialysis; they are often recommended throughout the day to manage the condition.

4. A client has expressive aphasia following a stroke. Which of the following methods should be used when communicating with the client?

• A. Speak slowly
• B. Provide written instructions
• C. Use a picture board
• D. Write on a whiteboard

Correct answer: C

Rationale: When communicating with a client who has expressive aphasia, using a picture board is an effective method as it provides an alternative means of communication. Option A, speaking slowly, may not improve understanding for someone with expressive aphasia. Option B, providing written instructions, may also be challenging for individuals with this condition. Option D, writing on a whiteboard, may not be as helpful as using a picture board in facilitating communication for a client with expressive aphasia.

5. A client receiving chemotherapy reports nausea and vomiting. What is the nurse's priority intervention?

• A. Administer antiemetic medication before meals
• B. Encourage the client to eat small, frequent meals
• C. Instruct the client to avoid eating during treatment
• D. Provide the client with cold beverages during meals

Correct answer: A

Rationale: The correct answer is A: Administer antiemetic medication before meals. When a client receiving chemotherapy reports nausea and vomiting, administering antiemetic medication before meals is a priority intervention to help reduce nausea associated with chemotherapy. This proactive approach can prevent or minimize the symptoms, improving the client's quality of life during treatment. Choice B is incorrect because while encouraging the client to eat small, frequent meals can be helpful, administering antiemetic medication is the priority to address the immediate symptoms. Choice C is incorrect as avoiding eating during treatment may lead to nutritional deficits, and choice D is incorrect because providing cold beverages during meals may not effectively address the nausea and vomiting symptoms.

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