Nursing Elites

1. A nurse is providing discharge teaching for a group of clients. The nurse should recommend a referral to a dietitian.

• A. A client who has a prescription for warfarin and states, 'I will need to limit how much spinach I eat.'
• B. A client who has gout and states, 'I can continue to eat anchovies on my pizza.'
• C. A client who has a prescription for spironolactone and states, 'I will reduce my intake of foods that contain potassium.'
• D. A client who has osteoporosis and states, 'I'll plan to take my calcium carbonate with a full glass of water.'

Correct answer: C

Rationale: The correct answer is C. Spironolactone is a potassium-sparing diuretic, which means it helps the body retain potassium and excrete sodium and water. Therefore, clients on spironolactone should reduce their intake of foods high in potassium to prevent hyperkalemia. Choices A, B, and D are incorrect because limiting spinach intake due to warfarin, eating anchovies with gout, and taking calcium carbonate with water for osteoporosis do not directly relate to the medication's side effects or dietary restrictions associated with spironolactone.

2. A nurse is caring for a client who has pneumonia. Which of the following manifestations should the nurse expect?

• A. Bradycardia
• B. Hypertension
• C. Tachypnea
• D. Hypothermia

Correct answer: C

Rationale: The correct answer is C: Tachypnea. When caring for a client with pneumonia, the nurse should expect tachypnea, which is rapid breathing. This occurs due to decreased oxygenation and lung function. Bradycardia (A) is not typically associated with pneumonia; instead, tachycardia may be present. Hypertension (B) is not a common manifestation of pneumonia; instead, hypotension may occur due to sepsis. Hypothermia (D) is not a typical finding in pneumonia; fever or an elevated temperature is more common.

3. A client requests the creation of a living will. Which of the following actions should the nurse take?

• A. Schedule a meeting between the hospital ethics committee and the client
• B. Evaluate the client's understanding of life-sustaining measures
• C. Determine the client's preferences about post-mortem care
• D. Request a conference with the client's family

Correct answer: B

Rationale: The correct action for the nurse to take when a client requests the creation of a living will is to evaluate the client's understanding of life-sustaining measures. This step is crucial to ensure that the client is well-informed about their options before making decisions regarding their future care. Scheduling a meeting with the hospital ethics committee (choice A) may not be necessary at this stage and could overwhelm the client. Determining the client's preferences about post-mortem care (choice C) is not directly related to creating a living will. Requesting a conference with the client's family (choice D) may be important later but is not the initial step in this situation.

4. A client in active labor is being assessed by a nurse. Which of the following findings should the nurse report to the provider?

• A. Contractions lasting 80 seconds.
• B. FHR baseline of 170/min.
• C. Early decelerations in the FHR.
• D. Temperature of 37.4°C (99.3°F).

Correct answer: B

Rationale: The correct answer is B because a baseline FHR of 170/min indicates fetal tachycardia, which needs further evaluation. Choice A about contractions lasting 80 seconds is within the normal range for active labor. Choice C, early decelerations in the FHR, are generally considered benign and do not require immediate reporting. Choice D, a temperature of 37.4°C (99.3°F), falls within normal limits for a laboring client and does not warrant immediate reporting.

5. A client at risk for osteoporosis is being taught by a nurse about dietary measures to increase calcium intake. Which of the following foods should the nurse recommend?

• A. Carrots
• B. Cottage cheese
• C. Bananas
• D. Broccoli

Correct answer: D

Rationale: The correct answer is D: Broccoli. Broccoli is high in calcium, making it a suitable recommendation for clients at risk for osteoporosis. Carrots, Cottage cheese, and Bananas are not significant sources of calcium compared to broccoli, and therefore, they are not the best choices to increase calcium intake.

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