Nursing Elites

1. A nurse is reinforcing teaching with a client who has dumping syndrome about measures to reduce manifestations. Which of the following instructions should the nurse include in the teaching?

• A. Drink plenty of fluids after meals
• B. Increase sugar intake
• C. Eat smaller, more frequent meals
• D. Avoid foods high in sugar content

Correct answer: D

Rationale: The correct instruction the nurse should include in teaching a client with dumping syndrome is to 'Avoid foods high in sugar content.' Dumping syndrome occurs when high-sugar foods move too quickly into the small intestine, leading to symptoms like abdominal cramps, diarrhea, and bloating. By avoiding foods high in sugar content, the client can reduce these symptoms. Choices A, B, and C are incorrect. Drinking plenty of fluids after meals may exacerbate symptoms by speeding up the movement of food through the digestive system. Increasing sugar intake would worsen dumping syndrome symptoms. While eating smaller, more frequent meals is a good strategy, the key emphasis should be on avoiding high-sugar foods.

2. What are the side effects of chemotherapy, and how should they be managed?

• A. Nausea, vomiting; manage with antiemetics
• B. Hair loss and anemia; manage with blood transfusions
• C. Diarrhea and fatigue; manage with hydration
• D. Weight gain and high blood pressure; manage with diuretics

Correct answer: A

Rationale: The correct side effects of chemotherapy mentioned in this question are nausea and vomiting. These side effects are commonly managed with antiemetics to improve the quality of life for patients undergoing chemotherapy. Choice B (Hair loss and anemia) is incorrect as hair loss and anemia are potential side effects of chemotherapy but are not addressed in this question. Choice C (Diarrhea and fatigue) is also incorrect as it does not match the side effects provided. Choice D (Weight gain and high blood pressure) is inaccurate as these are not typical side effects of chemotherapy.

3. A client with a tracheostomy is experiencing increased secretions and labored breathing. What should the nurse do first?

• A. Administer a bronchodilator
• B. Suction the tracheostomy
• C. Encourage the client to cough
• D. Notify the provider

Correct answer: B

Rationale: The correct answer is to suction the tracheostomy first. When a client with a tracheostomy is experiencing increased secretions and labored breathing, suctioning the tracheostomy is the priority intervention to clear the airway and improve breathing. Administering a bronchodilator (Choice A) may help with breathing but should come after ensuring the airway is clear. Encouraging the client to cough (Choice C) may not be effective in clearing secretions from the tracheostomy. Notifying the provider (Choice D) can be done after ensuring immediate airway clearance.

4. What is the most important intervention when managing a client with delirium?

• A. Administer a sedative to reduce agitation
• B. Identify any reversible causes of delirium
• C. Increase environmental stimulation
• D. Limit noise and provide a calm environment

Correct answer: B

Rationale: The correct answer is B: 'Identify any reversible causes of delirium.' When managing a client with delirium, it is crucial to first identify and address any reversible factors contributing to the delirium. Administering sedatives (Choice A) may worsen delirium and is not the primary intervention. Increasing environmental stimulation (Choice C) can exacerbate symptoms. Limiting noise and providing a calm environment (Choice D) are beneficial but not as crucial as identifying reversible causes.

5. A nurse in a long-term care facility is auscultating the lung sounds of a client who reports shortness of breath and increased fatigue. The nurse should report which of the following to the provider after hearing this sound?

• A. Fine crackles
• B. Rhonchi
• C. Wheezing
• D. Stridor

Correct answer: A

Rationale: The correct answer is A: Fine crackles. Fine crackles suggest fluid in the lungs, which could indicate a serious respiratory issue like pulmonary edema. This sound should be reported to the provider for further evaluation and possible intervention. Rhonchi (choice B) are low-pitched wheezing sounds often caused by secretions in the larger airways, wheezing (choice C) is a high-pitched whistling sound usually caused by narrowed airways, and stridor (choice D) is a high-pitched sound heard on inspiration that indicates upper airway obstruction. While these sounds also require attention, fine crackles are more indicative of fluid accumulation in the lungs, making them the priority for reporting in this scenario.

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