Nursing Elites

1. A client with meningitis is being assessed by a healthcare provider. Which of the following findings should the provider expect?

• A. Negative Brudzinski’s sign.
• B. Flaccid neck muscles.
• C. Petechial rash.
• D. Hypoactive deep tendon reflexes.

Correct answer: C

Rationale: A petechial rash is a characteristic finding in clients with meningitis, indicating small, pinpoint hemorrhages under the skin. This rash results from the infection's impact on the blood vessels. Petechiae are important to recognize as they can help differentiate meningitis from other conditions with similar symptoms. Brudzinski’s sign, neck stiffness, and positive Kernig’s sign are more common physical exam findings in meningitis. Flaccid neck muscles and hypoactive deep tendon reflexes are not typically associated with meningitis.

2. A healthcare professional is preparing to administer a subcutaneous injection. Which of the following actions should the healthcare professional take?

• A. Use a 1-inch needle.
• B. Insert the needle at a 90-degree angle.
• C. Use a tuberculin syringe.
• D. Aspirate before injecting.

Correct answer: B

Rationale: When administering a subcutaneous injection, it is important to insert the needle at a 90-degree angle to ensure proper medication delivery into the subcutaneous tissue. This angle helps prevent the medication from being injected too deeply or too superficially, ensuring optimal absorption and therapeutic effect. Choice A is incorrect because the needle length for a subcutaneous injection is typically shorter, around ⅝ to 1 inch. Choice C is incorrect as a tuberculin syringe is not commonly used for subcutaneous injections. Choice D is also incorrect as aspiration is not necessary for subcutaneous injections since there are minimal blood vessels in the subcutaneous tissue.

3. What action should the healthcare provider take for a patient with a chest tube?

• A. Strip the drainage tubing every 4 hours.
• B. Keep the drainage system below the level of the patient's chest.
• C. Clamp the chest tube when ambulating the patient.
• D. Ensure the water seal chamber is filled to the prescribed level.

Correct answer: D

Rationale: Ensuring the water seal chamber is filled to the prescribed level is essential for the chest tube's effective functioning. This maintains the integrity of the system, prevents air from entering the pleural space, and facilitates proper drainage. Stripping the drainage tubing, keeping the drainage system below the chest level, or clamping the chest tube during ambulation are not recommended practices and can lead to complications.

4. A client with a new diagnosis of chronic kidney disease is being taught about dietary management. Which of the following statements should be included in the teaching?

• A. Increase your intake of protein-rich foods.
• B. Decrease your intake of phosphorus-rich foods.
• C. Avoid foods that contain lactose.
• D. Increase your intake of potassium-rich foods.

Correct answer: B

Rationale: In chronic kidney disease, decreasing the intake of phosphorus-rich foods is essential as impaired kidney function can lead to difficulty in excreting phosphorus, causing an imbalance. This can result in bone and heart complications. Therefore, educating the client to reduce phosphorus intake is crucial for managing the disease and preventing further complications. Option A is incorrect because excessive protein intake can burden the kidneys. Option C is not directly related to the management of chronic kidney disease. Option D is also incorrect as potassium intake may need to be limited in certain stages of kidney disease.

5. A client with a new diagnosis of hyperlipidemia is receiving teaching from a healthcare provider. Which of the following statements by the client indicates an understanding of the teaching?

• A. I will decrease my intake of fiber.
• B. I will increase my intake of red meat.
• C. I will decrease my intake of saturated fats.
• D. I will increase my intake of salt.

Correct answer: C

Rationale: The correct answer is C. Decreasing saturated fats is essential in managing hyperlipidemia. Saturated fats can raise LDL cholesterol levels, contributing to the condition. By reducing intake of saturated fats, the client can help lower their cholesterol levels and improve their overall lipid profile. Choices A, B, and D are incorrect. Decreasing fiber intake (Choice A) is not recommended as fiber can help lower cholesterol levels. Increasing red meat intake (Choice B) is not advisable as red meat is often high in saturated fats. Increasing salt intake (Choice D) is unrelated to managing hyperlipidemia and can even be detrimental due to its association with high blood pressure.

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