Nursing Elites

1. A nurse is providing dietary teaching to a client with irritable bowel syndrome (IBS). Which dietary recommendation should be included?

• A. Consume food high in bran fiber.
• B. Increase intake of milk products.
• C. Sweeten foods with fructose corn syrup.
• D. Increase foods high in gluten.

Correct answer: A

Rationale: The correct answer is A: Consume food high in bran fiber. Bran fiber helps reduce IBS symptoms by promoting regular bowel movements. Choices B, C, and D are incorrect because increasing milk products can exacerbate symptoms in some individuals with IBS, sweetening foods with fructose corn syrup may worsen symptoms due to its high FODMAP content, and increasing foods high in gluten could be problematic for individuals with gluten sensitivities or celiac disease, which are common in some with IBS.

2. What is the initial action for a healthcare provider when a patient presents with shortness of breath?

• A. Administer oxygen
• B. Reposition the patient
• C. Check for abnormal breath sounds
• D. Check oxygen saturation

Correct answer: A

Rationale: Administering oxygen is the initial action for a healthcare provider when a patient presents with shortness of breath because it helps alleviate the patient's symptoms by improving oxygenation. Providing oxygen takes precedence over other actions such as repositioning the patient, checking for abnormal breath sounds, or assessing oxygen saturation. While these actions are important, ensuring the patient has an adequate oxygen supply is crucial in the initial management of shortness of breath.

3. A nurse is caring for a client who has a pulmonary embolism. The nurse should identify the effectiveness of the treatment by assessing which of the following?

• A. A chest x-ray reveals increased density in all lung fields
• B. The client reports feeling less anxious
• C. Diminished breath sounds are auscultated unilaterally
• D. ABG results include pH 7.48, PaO2 77 mm Hg, and PaCO2 47 mm Hg

Correct answer: B

Rationale: The correct answer is B. Client-reported improvement in anxiety is an indication of effective treatment for pulmonary embolism. Choice A is incorrect as increased density in all lung fields on a chest x-ray may indicate complications or lack of improvement. Choice C is incorrect as diminished breath sounds auscultated unilaterally may suggest a localized lung issue and not necessarily reflect the effectiveness of treatment for a pulmonary embolism. Choice D is incorrect as the ABG results provided do not specifically indicate the effectiveness of treatment for a pulmonary embolism.

4. A group of newly licensed nurses is being taught about client advocacy by a nurse. Which of the following statements by a newly licensed nurse indicates an understanding of the teaching?

• A. I will intervene if there is a conflict between a client and their provider.
• B. I should not advocate for a client unless they are able to ask me themselves.
• C. I will inform a client that their family should help make their health care decisions.
• D. I believe the best health care decision is for the provider to decide.

Correct answer: B

Rationale: The correct answer is B because advocating for a client should not be dependent on the client's ability to ask for it personally. Advocacy is crucial to ensure clients' rights are upheld, especially when they are unable to express their wishes. Choice A is incorrect as intervening in a conflict may not always be advocating for the client's best interests. Choice C is incorrect because the family should not make health care decisions for the client without their input. Choice D is incorrect as it disregards the importance of client autonomy and involvement in decision-making.

5. What is the best method to assess for fluid overload in patients with heart failure?

• A. Monitor daily weight
• B. Check for jugular vein distention
• C. Check for pitting edema
• D. Check for fluid retention

Correct answer: A

Rationale: The correct answer is A: Monitor daily weight. Daily weight monitoring is the most accurate method to assess fluid overload in patients with heart failure. Changes in weight can indicate fluid retention before visible signs like jugular vein distention or pitting edema appear. Checking for jugular vein distention (choice B) is helpful but may not be as sensitive as daily weight monitoring. Pitting edema (choice C) and fluid retention (choice D) are signs of fluid overload, but daily weight monitoring is a more proactive approach to detect changes early.

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