Nursing Elites

1. A healthcare provider is providing dietary teaching to a client who has chronic kidney disease. Which of the following food choices should the healthcare provider recommend?

• A. A baked potato
• B. A chicken breast
• C. A banana
• D. A cup of orange juice

Correct answer: B

Rationale: The correct answer is B: A chicken breast. Chicken breast is low in potassium, making it a safe option for clients with chronic kidney disease who need to limit their potassium intake. Foods like bananas and orange juice are high in potassium, which should be avoided or limited by individuals with chronic kidney disease to prevent further kidney damage.

2. A provider has written a do not resuscitate (DNR) order for a client who is comatose and does not have advance directives. A member of the client’s family says, 'I wonder when the doctor will tell us what’s going on.' Which of the following actions should the nurse take first?

• A. Request that the provider provide more information to the family.
• B. Refer the family to a support group for grief counseling.
• C. Offer to answer questions that family members have.
• D. Ask the family what the provider has discussed with them.

Correct answer: D

Rationale: The correct action for the nurse to take first is to ask the family what the provider has discussed with them. This allows the nurse to clarify any misunderstandings and ensures that the family is fully informed before providing further information. Option A is not the best choice because it assumes the need for more information without first understanding what has already been communicated. Option B is premature as the family may not be ready for grief counseling at this stage. Option C, although a good general practice, is not the most appropriate immediate action in this situation where clarifying existing information is crucial.

3. A client gave birth 4 hours ago and is experiencing excessive vaginal bleeding. Which of the following actions should the nurse plan to take first?

• A. Elevate the client's legs to a 30° angle
• B. Insert an indwelling urinary catheter
• C. Massage the client's fundus
• D. Initiate an infusion of oxytocin

Correct answer: C

Rationale: The correct answer is to massage the client's fundus first. Uterine atony is a common cause of postpartum hemorrhage, and massaging the fundus can help stimulate uterine contractions, which will assist in reducing bleeding. Elevating the client's legs to a 30° angle (Choice A) is not the priority in this situation as fundal massage takes precedence. Inserting an indwelling urinary catheter (Choice B) may be necessary but should not take precedence over managing the postpartum hemorrhage. Initiating an infusion of oxytocin (Choice D) is a valid intervention to address uterine atony, but massaging the fundus should come first to promote immediate contraction and control bleeding.

4. A nurse is caring for a client with celiac disease. Which food should be removed from the meal tray?

• A. Cornbread
• B. Mashed potatoes
• C. Lentils
• D. Tortillas

Correct answer: D

Rationale: The correct answer is D, Tortillas. Clients with celiac disease should avoid gluten, which is often found in tortillas. Cornbread, mashed potatoes, and lentils are gluten-free options, making them safe for individuals with celiac disease. Therefore, the other choices (A, B, and C) do not need to be removed from the meal tray.

5. A healthcare provider is educating a patient on the use of alendronate. Which of the following should be included?

• A. Take it with food
• B. Take it once a week
• C. It can be taken at bedtime
• D. Monitor for increased appetite

Correct answer: B

Rationale: The correct answer is B: 'Take it once a week.' Alendronate is typically taken once a week to treat osteoporosis. It should be taken on an empty stomach in the morning with a full glass of water. Choice A is incorrect because alendronate should be taken on an empty stomach, not with food. Choice C is incorrect because alendronate should be taken in the morning, not at bedtime. Choice D is unrelated to alendronate use and not a common side effect associated with this medication.

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