Nursing Elites

1. A healthcare provider is assessing a client who has fluid volume excess. Which of the following findings should the healthcare provider expect?

• A. Hypotension
• B. Bradycardia
• C. Crackles in the lungs
• D. Dry mucous membranes

Correct answer: C

Rationale: Crackles in the lungs are indicative of fluid accumulation in the alveoli, which is a characteristic finding in clients with fluid volume excess. The crackling sound occurs due to the presence of excess fluid in the lungs, impairing normal ventilation and gas exchange. Monitoring for crackles is essential for early detection and management of fluid overload in clients. Choices A, B, and D are incorrect because in fluid volume excess, hypervolemia leads to increased blood pressure (not hypotension), compensatory tachycardia (not bradycardia), and moist mucous membranes (not dry).

2. A healthcare provider is planning to administer medications to a client who is receiving enteral feedings through an NG tube. Which of the following actions should the healthcare provider plan to take?

• A. Dissolve each medication in 5 mL of sterile water.
• B. Administer medications through a secondary infusion.
• C. Mix medications with the enteral feeding.
• D. Flush the NG tube with 30 mL of water before and after administering medications.

Correct answer: D

Rationale: Flushing the NG tube with water before and after administering medications is essential to prevent clogging of the tube and ensure proper delivery of medication. This practice helps maintain tube patency and decreases the risk of obstruction, which could compromise the client's treatment and nutrition. By flushing the tube, the healthcare provider ensures that the medication is completely delivered and that there are no residual drug particles left in the tube, which could lead to blockages or inconsistent dosing. Therefore, flushing the NG tube is a crucial step in the safe administration of medications to clients receiving enteral feedings. Choices A, B, and C are incorrect. Dissolving medications in sterile water (Choice A) may not be suitable for all drugs, as some medications may require specific diluents. Administering medications through a secondary infusion (Choice B) is not the standard practice for enteral medication administration. Mixing medications with the enteral feeding (Choice C) can cause interactions between medications and the feeding formula, affecting their absorption and effectiveness.

3. A healthcare provider is preparing to administer an intramuscular injection to an adult client. Which of the following injection sites should the healthcare provider select?

• A. Deltoid muscle
• B. Dorsogluteal muscle
• C. Vastus lateralis muscle
• D. Rectus femoris muscle

Correct answer: A

Rationale: The deltoid muscle is a common site for intramuscular injections in adults due to its accessibility and muscle mass. It is located in the upper arm and provides a sufficient area for injection. The deltoid muscle is preferred for administering vaccines and other medications that require IM administration. Choice B, the dorsogluteal muscle, is not recommended for intramuscular injections due to the proximity of major nerves and blood vessels in that area, which can lead to nerve damage or injury. Choice C, the vastus lateralis muscle, is more commonly used for infants and young children, while choice D, the rectus femoris muscle, is not typically used for intramuscular injections in adults.

4. A client with ulcerative colitis is receiving dietary management education from a healthcare provider. Which statement by the client indicates an understanding of the teaching?

• A. I should increase my intake of dairy products.
• B. I should decrease my intake of dairy products.
• C. I should increase my intake of high-fiber foods.
• D. I should decrease my intake of high-fat foods.

Correct answer: B

Rationale: The correct answer is B because reducing dairy product intake can help manage symptoms of ulcerative colitis. Dairy products can exacerbate symptoms in some individuals due to their lactose content and may need to be limited or avoided based on individual tolerance levels. Choice A is incorrect because increasing dairy products can worsen symptoms for some ulcerative colitis patients. Choice C is incorrect as while high-fiber foods are generally beneficial, they may exacerbate symptoms during a flare-up. Choice D is also incorrect as while reducing high-fat foods can be beneficial, dairy products are a more specific concern for ulcerative colitis.

5. A client has a new diagnosis of hypothyroidism, and a nurse is providing dietary management education. Which of the following statements should the nurse include in the teaching?

• A. You should increase your intake of iodine-rich foods.
• B. You should decrease your intake of iodine-rich foods.
• C. You should avoid foods that contain lactose.
• D. You should increase your intake of dairy products.

Correct answer: A

Rationale: In hypothyroidism, increasing intake of iodine-rich foods is beneficial as iodine is essential for the production of thyroid hormones. This helps to support thyroid function in individuals with hypothyroidism. Therefore, advising the client to increase their intake of iodine-rich foods aligns with the recommended dietary management for hypothyroidism. Choice B is incorrect because decreasing iodine-rich foods could lead to further deficiency in individuals with hypothyroidism. Choice C is not directly related to hypothyroidism and lactose intolerance is a separate issue. Choice D is incorrect as increasing dairy products is not a specific recommendation for hypothyroidism unless the client has a deficiency of calcium or vitamin D, which should be assessed separately.

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