Nursing Elites

1. A nurse is providing dietary teaching to a client who has cholecystitis. Which of the following foods should the nurse instruct the client to avoid?

• A. Bananas.
• B. Oatmeal.
• C. Brown rice.
• D. Whole milk.

Correct answer: D

Rationale: The correct answer is D: Whole milk. Clients with cholecystitis should avoid high-fat foods, and whole milk contains high levels of fat. Bananas, oatmeal, and brown rice are generally considered safe for clients with cholecystitis as they are low in fat and easily digestible. Bananas are a good source of potassium, oatmeal is high in fiber, and brown rice provides complex carbohydrates. Therefore, the nurse should advise the client to avoid whole milk but can recommend the other choices as part of a balanced diet for cholecystitis.

2. When discussing clients designating a health care proxy in situations requiring a durable power of attorney for health care (DPAHC), what information should the charge nurse include?

• A. The proxy should make health care decisions for the client regardless of the client's ability to do so.
• B. The proxy can make financial decisions if the need arises.
• C. The proxy can make treatment decisions if the client is under anesthesia.
• D. The proxy should manage legal issues for the client.

Correct answer: C

Rationale: The correct answer is C. The charge nurse should include information that the proxy can make treatment decisions if the client is under anesthesia. This is a key function of a durable power of attorney for health care. Choices A, B, and D are incorrect because a health care proxy's role is specifically related to making health care decisions, not financial decisions, legal issues, or decisions made under anesthesia.

3. A nurse is reviewing the laboratory results of a client who has rheumatoid arthritis and is prescribed methotrexate. Which of the following results should the nurse report to the provider?

• A. White blood cell count 8,000/mm3
• B. Platelet count 150,000/mm3
• C. Hemoglobin 14 g/dL
• D. Aspartate aminotransferase (AST) 60 units/L

Correct answer: D

Rationale: The correct answer is D: Aspartate aminotransferase (AST) 60 units/L. An elevated AST level indicates liver damage, a side effect of methotrexate, and should be reported. Choices A, B, and C are within normal ranges and do not indicate potential complications related to methotrexate therapy.

4. A client has a new diagnosis of hypertension, and a nurse is teaching about dietary management. Which of the following instructions should the nurse include?

• A. Limit your sodium intake to 2,000 mg per day.
• B. Increase your intake of high-fat foods.
• C. Increase your intake of green, leafy vegetables.
• D. Limit your potassium intake to 3,000 mg per day.

Correct answer: A

Rationale: The correct answer is A: Limit your sodium intake to 2,000 mg per day. Limiting sodium intake helps manage hypertension by reducing fluid retention and lowering blood pressure. Choice B is incorrect because increasing intake of high-fat foods can worsen hypertension by contributing to weight gain and other cardiovascular risks. Choice C is incorrect as green, leafy vegetables are beneficial for hypertension due to their high potassium and other nutrient content. Choice D is incorrect as limiting potassium intake is typically not recommended for hypertension management unless specified by a healthcare provider.

5. A nurse is caring for a client who is at risk for developing deep vein thrombosis (DVT). Which of the following actions should the nurse implement?

• A. Massage the client's legs every 2 hours.
• B. Encourage the client to remain on bed rest.
• C. Apply sequential compression devices to the client's legs.
• D. Administer anticoagulants as prescribed.

Correct answer: C

Rationale: The correct action the nurse should implement is to apply sequential compression devices to the client's legs. This intervention helps prevent venous stasis and reduce the risk of deep vein thrombosis (DVT). Massaging the client's legs may dislodge a clot and is contraindicated in this situation (choice A). Encouraging bed rest may increase the risk of DVT due to prolonged immobility (choice B). While administering anticoagulants is a common treatment for DVT, in this case, the question is about preventive measures, and using sequential compression devices is a non-pharmacological approach.

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