Nursing Elites

1. A nurse is reviewing the medical records of a client with chronic heart failure. What dietary recommendation should the nurse make?

• A. Follow a 3g sodium diet.
• B. Drink at least 3 liters of fluid per day.
• C. Place the client's lower extremities on two pillows.
• D. Maintain the client's oxygen saturation at 89%.

Correct answer: A

Rationale: The correct answer is A: Follow a 3g sodium diet. For clients with chronic heart failure, limiting sodium intake is crucial to prevent fluid retention and exacerbation of heart failure symptoms. High sodium intake can lead to fluid buildup, causing the heart to work harder. Choices B, C, and D are incorrect. Drinking excessive fluid can worsen fluid retention in heart failure, elevating the workload of the heart. Placing the client's lower extremities on two pillows is a positioning intervention to alleviate edema, not a dietary recommendation. Maintaining oxygen saturation at 89% is more related to respiratory status rather than dietary management of chronic heart failure.

2. A client at 32 weeks of gestation with preeclampsia is receiving teaching from a nurse. Which statement by the client indicates an understanding of the teaching?

• A. I will take a daily aspirin to prevent blood clots.
• B. I will call my provider if I experience swelling in my hands.
• C. I should increase my calcium intake to prevent seizures.
• D. I will restrict my protein intake to prevent further kidney damage.

Correct answer: B

Rationale: The correct answer is B because swelling in the hands is a potential sign of worsening preeclampsia, and the client should report this to their provider. Choice A is incorrect since aspirin is not recommended in preeclampsia. Choice C is incorrect as calcium intake is not directly related to preventing seizures in preeclampsia. Choice D is incorrect because protein restriction is not the standard management for preventing further kidney damage in preeclampsia.

3. What is the best dietary recommendation for a patient with chronic liver disease?

• A. Low protein diet
• B. High protein diet
• C. Low sodium diet
• D. High sodium diet

Correct answer: A

Rationale: The best dietary recommendation for a patient with chronic liver disease is a low protein diet. In liver disease, the liver may have difficulty processing protein, leading to the accumulation of toxins like ammonia in the body. A low protein diet helps reduce the burden on the liver and minimizes the production of these harmful substances. High protein diets can exacerbate the condition by increasing the workload on the liver. A low sodium diet (Choice C) is also important for liver disease patients as excess sodium can contribute to fluid retention and swelling, but reducing protein intake is the primary focus in these cases.

4. A client, 12 hours postpartum, reports not having a bowel movement for 4 days. Which medication should the nurse administer?

• A. Bisacodyl 10 mg rectal suppository.
• B. Magnesium hydroxide 30 ml PO.
• C. Famotidine 20 mg PO.
• D. Loperamide 4 mg PO.

Correct answer: A

Rationale: In this scenario, the nurse should administer Bisacodyl 10 mg rectal suppository. The client's report of not having a bowel movement for 4 days indicates constipation, and Bisacodyl is a stimulant laxative that helps initiate bowel movements. Magnesium hydroxide is an antacid and osmotic laxative used for indigestion, not for constipation. Famotidine is an H2 receptor antagonist used to reduce stomach acid production and treat heartburn, not constipation. Loperamide is an antidiarrheal agent and would be contraindicated in a client experiencing constipation.

5. Which electrolyte imbalance is commonly seen in patients taking furosemide?

• A. Hypokalemia
• B. Hyponatremia
• C. Hyperkalemia
• D. Hypercalcemia

Correct answer: A

Rationale: The correct answer is A: Hypokalemia. Furosemide, a loop diuretic, can lead to potassium loss in the urine, resulting in hypokalemia. This electrolyte imbalance is commonly seen in patients taking furosemide and requires close monitoring. Choices B, C, and D are incorrect because furosemide does not typically cause hyponatremia, hyperkalemia, or hypercalcemia as frequently as it causes hypokalemia.

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