Nursing Elites

1. A client with hypertension is prescribed a thiazide diuretic. What dietary recommendation should the nurse make?

• A. Encourage a diet low in carbohydrates and fats.
• B. Avoid foods high in vitamin K, such as spinach and kale.
• C. Increase salt intake to prevent dehydration.
• D. Eat potassium-rich foods like bananas and oranges.

Correct answer: D

Rationale: The correct answer is D: 'Eat potassium-rich foods like bananas and oranges.' Thiazide diuretics can lead to potassium loss, so it is essential for clients to consume potassium-rich foods to maintain adequate levels. Choice A is incorrect because focusing solely on low carbohydrates and fats does not address the specific issue of potassium loss. Choice B is unrelated as vitamin K content is not a concern with thiazide diuretics. Choice C is incorrect as increasing salt intake would exacerbate hypertension and not prevent dehydration.

2. A client with a colostomy is being discharged. What teaching is most important for the nurse to provide?

• A. Change the ostomy bag daily to prevent skin irritation.
• B. Avoid foods that can cause gas, such as broccoli.
• C. Empty the ostomy pouch when it is one-third full.
• D. Use a skin barrier to protect the surrounding skin.

Correct answer: C

Rationale: The most important teaching for a client with a colostomy is to empty the ostomy pouch when it is one-third full. This practice helps prevent leakage and skin irritation by maintaining the proper seal of the pouching system. Changing the ostomy bag daily (Choice A) is not necessary unless it leaks or becomes loose. Avoiding gas-producing foods (Choice B) is essential for some clients but is not the most important teaching. Using a skin barrier (Choice D) is important but not as crucial as emptying the ostomy pouch at the right time to prevent complications.

3. A client with a history of atrial fibrillation is prescribed warfarin. What is the nurse's priority teaching?

• A. Avoid eating foods high in potassium.
• B. Avoid foods high in vitamin K.
• C. Take the medication on an empty stomach.
• D. Take the medication at bedtime for best results.

Correct answer: B

Rationale: The correct answer is B: 'Avoid foods high in vitamin K.' Warfarin is an anticoagulant medication that works by interfering with vitamin K-dependent clotting factors. Therefore, consuming foods high in vitamin K can affect the medication's effectiveness. Choices A, C, and D are incorrect because: A) Warfarin is not affected by foods high in potassium; C) Warfarin should be taken with food to minimize gastrointestinal side effects; D) There is no specific requirement for taking warfarin at bedtime for best results.

4. A 4-year-old child falls off a tricycle and is admitted for observation. How can the nurse best facilitate the child's cooperation during the assessment?

• A. Ask the parent to hold the child during the assessment.
• B. Allow the child to play with a syringe without a needle.
• C. Ask the child to blow out the penlight as if to simulate success.
• D. Explain the function of each organ during the assessment.

Correct answer: C

Rationale: Engaging the child in blowing out the penlight simulates play and can reduce fear, helping with cooperation during the assessment. Choice A is not recommended as it may increase anxiety by separating the child from the parent. Choice B is not appropriate as it involves playing with a syringe, which may not be safe or suitable. Choice D is not ideal for a 4-year-old child as understanding organ functions may be beyond their developmental level.

5. A client with Alzheimer’s disease is becoming increasingly confused. What action should the nurse take first?

• A. Reorient the client to time and place.
• B. Monitor the client’s vital signs.
• C. Provide the client with calming activities to reduce confusion.
• D. Consult with the healthcare provider about adjusting the client’s medication.

Correct answer: B

Rationale: The correct action for the nurse to take first when a client with Alzheimer’s disease is becoming increasingly confused is to monitor the client’s vital signs (Choice B). Increased confusion in Alzheimer’s disease patients may indicate underlying issues like infection, dehydration, or medication side effects. Monitoring vital signs is crucial in identifying any potential causes of the confusion. Choices A, C, and D are not the priority in this situation. Reorienting the client to time and place (Choice A) can be helpful but is not the first priority. Providing calming activities (Choice C) and consulting with the healthcare provider about medication adjustments (Choice D) may be necessary but should come after assessing the client's vital signs to rule out immediate physical causes of confusion.

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