Nursing Elites

1. A nurse is planning care for a client following gastric bypass surgery. The nurse should include which of the following dietary instructions when preparing the client for discharge?

• A. Start each meal with a protein source.
• B. Consume at least 25g of fiber daily.
• C. Check your blood glucose level before each meal.
• D. Limit your meals to three times per day.

Correct answer: A

Rationale: The correct answer is A: 'Start each meal with a protein source.' Protein is crucial for healing and maintaining muscle mass after gastric bypass surgery, making it essential to include in each meal. Choice B is incorrect because immediately after surgery, the focus is typically on a low-fiber diet to aid in healing. Choice C is unrelated to the nutritional needs following gastric bypass surgery. Choice D is also incorrect as patients recovering from gastric bypass surgery may require more frequent, smaller meals to meet their nutritional needs.

2. A nurse is preparing to administer IV furosemide. Which of the following should the nurse monitor for during the infusion?

• A. Increased urinary output
• B. Ototoxicity
• C. Hypokalemia
• D. Hypoglycemia

Correct answer: C

Rationale: The correct answer is C: Hypokalemia. Furosemide is a loop diuretic that works by increasing the excretion of water and electrolytes, particularly potassium. Therefore, the nurse should monitor for hypokalemia, as low potassium levels can lead to various complications such as cardiac dysrhythmias. Choice A, increased urinary output, is an expected effect of furosemide due to its diuretic action but is not a side effect needing monitoring. Ototoxicity (Choice B) is a potential adverse effect of other medications like aminoglycoside antibiotics, not furosemide. Hypoglycemia (Choice D) is not a common side effect associated with furosemide administration.

3. A nurse in an acute care facility is caring for a client who is postop following abdominal surgery. Which of the following behaviors should the nurse identify as increasing the client's risk for constipation?

• A. Regular fluid intake
• B. Urge suppression
• C. Increased physical activity
• D. Adequate dietary fiber

Correct answer: B

Rationale: Urge suppression can lead to constipation by delaying bowel movements and causing fecal impaction, especially in postoperative patients. Regular fluid intake (choice A) is important to prevent constipation by maintaining hydration and aiding in bowel movements. Increased physical activity (choice C) helps stimulate bowel function and prevent constipation. Adequate dietary fiber (choice D) is essential for promoting healthy bowel movements and preventing constipation. However, urge suppression (choice B) is the behavior that directly contributes to constipation in this scenario.

4. A client newly prescribed sertraline is being taught by a nurse. Which statement by the client indicates understanding?

• A. I should take this medication with meals.
• B. I might have trouble sleeping when I start this medication.
• C. I should avoid drinking orange juice.
• D. I will feel better immediately after starting the medication.

Correct answer: B

Rationale: Choice B, 'I might have trouble sleeping when I start this medication,' indicates understanding because insomnia is a common side effect of sertraline, especially when initiating the medication. This statement shows the client comprehends a potential adverse effect and is prepared for it. Choices A, C, and D are incorrect. Taking sertraline with or without meals does not significantly affect its efficacy. There is no specific contraindication about drinking orange juice while on sertraline. Feeling better immediately after starting the medication is unlikely as sertraline usually takes some time to exert its therapeutic effects.

5. A nurse is preparing to administer a dose of enalapril. Which of the following should the nurse assess first?

• A. Heart rate
• B. Blood pressure
• C. Serum creatinine
• D. Potassium levels

Correct answer: B

Rationale: The correct answer is to assess blood pressure first. Enalapril is an ACE inhibitor commonly used to manage hypertension. It is crucial to evaluate the patient's blood pressure before administering enalapril to ensure it is within safe limits. Assessing other parameters like heart rate, serum creatinine, and potassium levels is also important but assessing blood pressure takes precedence due to the medication's mechanism of action and potential effects on blood pressure regulation.

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