Nursing Elites

1. A client with chronic kidney disease has been prescribed a low-protein diet. Which food should the healthcare provider advise the client to limit?

• A. Chicken breast
• B. Apple
• C. Rice
• D. Banana

Correct answer: A

Rationale: The correct answer is A: Chicken breast. In chronic kidney disease, a low-protein diet is often recommended to reduce the workload on the kidneys. Chicken breast is a high-protein food that should be limited in such diets to help manage the progression of kidney disease. Choices B, C, and D are low in protein and are generally suitable for individuals following a low-protein diet. Apples, rice, and bananas can be included in moderation as part of a balanced diet for individuals with chronic kidney disease.

2. The clinician is assessing a client with a Stage 2 skin ulcer. Which of the following treatments is most effective to promote healing?

• A. Covering the wound with a dry dressing
• B. Using hydrogen peroxide soaks
• C. Leaving the area open to dry
• D. Applying a hydrocolloid or foam dressing

Correct answer: D

Rationale: Applying a hydrocolloid or foam dressing is the most effective treatment to promote healing for a Stage 2 skin ulcer. These dressings create a moist environment that supports healing and prevents further tissue damage. Option A (covering the wound with a dry dressing) can lead to drying out the wound bed, hindering healing. Option B (using hydrogen peroxide soaks) can be too harsh and may damage the surrounding healthy tissue. Option C (leaving the area open to dry) can delay healing as it does not provide the necessary moist environment for optimal wound healing.

3. A healthcare professional is preparing to administer 750 mL of 0.9% sodium chloride IV to infuse over 7 hours. The healthcare professional should set the pump to deliver how many mL/hr?

• A. 107 mL/hr
• B. 75 mL/hr
• C. 90 mL/hr
• D. 60 mL/hr

Correct answer: A

Rationale: To calculate the mL/hr rate for the infusion, divide the total volume (750 mL) by the total time (7 hours). 750 mL ÷ 7 hours = 107 mL/hr. This means that the pump should be set to deliver approximately 107 mL/hr. Choice B (75 mL/hr) is incorrect because it does not reflect the correct calculation. Choice C (90 mL/hr) is incorrect as it does not align with the accurate calculation. Choice D (60 mL/hr) is incorrect as it does not match the correct mL/hr rate obtained through the calculation.

4. The nurse admits a 7 year-old to the emergency room after a leg injury. The x-rays show a femur fracture near the epiphysis. The parents ask what will be the outcome of this injury. The appropriate response by the nurse should be which of these statements?

• A. The injury is expected to heal quickly because of thin periosteum.
• B. In some instances the result is a retarded bone growth.
• C. Bone growth is stimulated in the affected leg.
• D. This type of injury shows more rapid union than that of younger children.

Correct answer: B

Rationale: A fracture near the epiphysis can result in retarded bone growth, so this should be communicated to the parents.

5. A client is grieving the loss of her partner and expresses thoughts of not wanting to live. Which of the following actions should the nurse take?

• A. Request additional support for the client from her family.
• B. Ask the client if she plans to harm herself.
• C. Inform the client that feeling this way is a normal response to grief.
• D. Suggest that the client seek counseling for support.

Correct answer: B

Rationale: The correct action for the nurse to take in this situation is to ask the client if she plans to harm herself. This is crucial to assess the client's risk of self-harm or suicide. Providing immediate safety and appropriate interventions is the priority when a client expresses such thoughts. Requesting additional support from the family (Choice A) may be helpful but does not address the immediate safety concern. Informing the client that feeling this way is normal (Choice C) may invalidate her feelings and does not address the safety risk. Suggesting counseling (Choice D) may be beneficial in the long term but is not the immediate priority when assessing for self-harm or suicide risk.

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