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. A healthcare professional is preparing information for a change-of-shift report. Which of the following information should the healthcare professional include in the report?

• A. Input and output measurements for the shift
• B. Blood pressure readings from the previous day
• C. Bone scan scheduled for today
• D. Medication regimen from the medication administration record

Correct answer: D

Rationale: During a change-of-shift report, healthcare professionals should include the medication regimen from the medication administration record. This information ensures continuity of care and helps incoming staff understand the patient's medication needs and schedule. While input and output measurements, blood pressure readings, and scheduled procedures like a bone scan are important aspects of patient care, they may not be immediately relevant for the incoming shift. Focusing on medication details helps prevent errors and ensures the patient receives the correct medications at the right times.

3. A client who has been experiencing frequent tonic-clonic seizures is being admitted by a nurse. Which of the following actions should the nurse include in the client's plan of care?

• A. Wrap blankets around all four sides of the bed.
• B. Place the client in a padded room.
• C. Maintain the bed in the lowest position.
• D. Ensure the client has a soft mattress.

Correct answer: C

Rationale: Maintaining the bed in the lowest position is crucial in reducing the risk of injury during tonic-clonic seizures. This action helps prevent falls and minimizes potential harm to the client. Wrapping blankets around all four sides of the bed (Choice A) may restrict movement during a seizure and increase the risk of injury. Placing the client in a padded room (Choice B) is not a practical approach in a healthcare setting and may not be feasible. Ensuring the client has a soft mattress (Choice D) alone does not address the safety concerns during seizures, unlike keeping the bed in the lowest position.

4. A client who has a new prescription for warfarin (Coumadin) is receiving discharge teaching from a nurse. Which of the following statements indicates that the client understands the teaching?

• A. I will take my warfarin at the same time every day.
• B. I should use a soft-bristled toothbrush while taking this medication.
• C. I should take my warfarin at bedtime.
• D. I should avoid eating foods high in vitamin K while taking this medication.

Correct answer: A

Rationale: The correct answer is A. Taking warfarin at the same time every day is essential to maintain a consistent blood level of the medication. This statement indicates that the client understands the teaching about the importance of consistency in medication timing. Choice B, regarding using a soft-bristled toothbrush, is not directly related to warfarin therapy and does not assess the client's understanding of warfarin administration. Choice C suggesting taking warfarin at bedtime is incorrect; it is generally recommended to take warfarin at the same time each day to avoid variations in drug levels. Choice D about avoiding foods high in vitamin K is relevant as vitamin K can interfere with warfarin's anticoagulant effects. However, it is not the best indicator of understanding the teaching on medication timing, which is crucial for warfarin efficacy.

5. A school-aged child has had a long leg (hip to ankle) synthetic cast applied 4 hours ago. Which statement from the mother indicates that teaching has been inadequate?

• A. I will keep the cast covered the next day to prevent skin burning.
• B. I can apply an ice pack over the area to relieve itching inside the cast.
• C. The cast should be propped on at least 2 pillows when my child is lying down.
• D. I think I remember that standing cannot be done until after 72 hours.

Correct answer: D

Rationale: The correct answer is D because there is no need to wait 72 hours before allowing the child to stand. The synthetic cast does not affect weight-bearing capacity, and standing can be done as tolerated. Choice A is incorrect because keeping the cast covered can lead to damage or accidents. Choice B is acceptable as applying an ice pack can help relieve itching. Choice C is also correct as elevating the cast on pillows can help reduce swelling and promote comfort during rest.

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