Nursing Elites

1. A nurse is caring for a client following an acute myocardial infarction. The client is concerned that providing self-care will be difficult due to extreme fatigue. Which of the following strategies should the nurse implement to promote the client's independence?

• A. Request an occupational therapy consult to determine the need for assistive devices
• B. Assign assistive personnel to perform self-care tasks for the client
• C. Instruct the client to focus on gradually resuming self-care tasks
• D. Ask the client if a family member is available to assist with his care

Correct answer: C

Rationale: Instructing the client to focus on gradually resuming self-care tasks is the most appropriate strategy to promote independence following an acute myocardial infarction. This approach allows the client to regain confidence and control over their self-care activities without feeling overwhelmed. Requesting an occupational therapy consult (Choice A) may be beneficial but is not the immediate solution to promote independence. Assigning assistive personnel (Choice B) to perform tasks for the client does not encourage independence. Asking if a family member is available for assistance (Choice D) does not directly promote the client's independence.

2. A client diagnosed with hypertension requires lifestyle changes. What change should the nurse emphasize?

• A. Increase intake of high-fat foods
• B. Reduce sodium intake
• C. Reduce intake of dairy products
• D. Increase intake of high-protein foods

Correct answer: B

Rationale: Reducing sodium intake is crucial for managing hypertension as excess sodium can lead to increased blood pressure. High-fat foods (Choice A) are not recommended as they can contribute to heart issues. While dairy products (Choice C) should be consumed in moderation, they are not specifically targeted in hypertension management. High-protein foods (Choice D) are not the priority; rather, reducing sodium intake takes precedence due to its direct impact on blood pressure levels.

3. Which dietary advice should a healthcare provider provide to a client with acute gout?

• A. Increase intake of dairy products
• B. Limit intake of red meat and shellfish
• C. Limit intake of fresh fruits and vegetables
• D. Limit intake of fruit juices and milk

Correct answer: B

Rationale: The correct dietary advice for a client with acute gout is to limit the intake of red meat and shellfish. These foods are high in purines, which can lead to increased uric acid levels in the body, exacerbating gout symptoms. Dairy products, fresh fruits, and vegetables are generally recommended for individuals with gout as they can help lower uric acid levels. Fruit juices and milk, in moderation, can also be part of a gout-friendly diet as they do not significantly contribute to uric acid buildup.

4. A nurse is caring for a client who is receiving intermittent enteral tube feedings. Which of the following places the client at risk for aspiration?

• A. A history of gastroesophageal reflux disease.
• B. Receiving a formula with high osmolarity.
• C. Sitting in a high-Fowler's position during the feeding.
• D. A residual of 65 mL 1 hour postprandial.

Correct answer: A

Rationale: The correct answer is A: A history of gastroesophageal reflux disease. Clients with gastroesophageal reflux disease have a higher risk of aspiration during tube feeding due to the potential for reflux of stomach contents into the lungs. This increases the risk of aspiration pneumonia. Choices B, C, and D are incorrect. High osmolarity formulas may cause diarrhea but do not directly increase the risk of aspiration. Sitting in a high-Fowler's position actually reduces the risk of aspiration by promoting proper digestion and reducing the chance of regurgitation. A residual of 65 mL 1 hour postprandial is within an acceptable range and does not directly indicate a risk for aspiration.

5. Which dietary instruction is appropriate for a client with chronic kidney disease?

• A. Increase the intake of potassium
• B. Limit the intake of phosphorus-rich foods
• C. Encourage the intake of protein-rich foods
• D. Advise the client to increase fluid intake

Correct answer: B

Rationale: Limiting the intake of phosphorus-rich foods is appropriate for a client with chronic kidney disease. In individuals with chronic kidney disease, the kidneys cannot filter phosphorus effectively, leading to a buildup in the blood. This can result in bone and heart problems. Therefore, reducing phosphorus intake is crucial to prevent complications. Choices A, C, and D are incorrect. Increasing potassium intake may be harmful as potassium levels can accumulate in the blood with impaired kidney function. Encouraging protein-rich foods may not be suitable as excessive protein intake can strain the kidneys. Advising to increase fluid intake should be done cautiously as individuals with chronic kidney disease may need to restrict fluids based on their stage of the disease.

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