Nursing Elites

1. A client is being taught about dietary management of hypercholesterolemia. Which of the following foods should be suggested to add to the diet?

• A. Avocados
• B. Fried chicken
• C. Whole milk
• D. Bacon

Correct answer: A

Rationale: Avocados are a good choice to suggest adding to the diet of a client with hypercholesterolemia because they are high in healthy fats, particularly monounsaturated fats, which can help manage cholesterol levels. On the other hand, fried chicken, whole milk, and bacon are high in saturated fats and cholesterol, which should be limited in a diet aimed at managing hypercholesterolemia. Therefore, choices B, C, and D are incorrect.

2. A female client with chronic back pain has been taking muscle relaxants and analgesics to manage the discomfort, but is now experiencing an acute episode of pain that is not relieved by this medication regime. The client tells the nurse that she does not want to have back surgery for a herniated intervertebral disk, and reports that she has found acupuncture effective in resolving past acute episodes. Which response is best for the nurse to provide?

• A. Surgery removes the disk and is the only treatment that can totally resolve the pain
• B. The medication regimen you previously used should be re-evaluated for dose adjustment
• C. Massage and hot pack treatments are less invasive and can provide temporary relief
• D. Acupuncture is a complementary therapy that is often effective for management of pain

Correct answer: D

Rationale: Acupuncture has been effective for the client previously, supporting continued use.

3. A healthcare professional is administering 1 L of 0.9% sodium chloride to a client who is postoperative and has fluid-volume deficit. Which of the following changes should the healthcare professional identify as an indication that the treatment was successful?

• A. Increase in hematocrit
• B. Increase in respiratory rate
• C. Decrease in heart rate
• D. Decrease in capillary refill time

Correct answer: C

Rationale: Fluid-volume deficit causes tachycardia. With correction of the imbalance, the heart rate should return to the expected range. An increase in hematocrit (Choice A) would indicate hemoconcentration, not a successful fluid replacement. An increase in respiratory rate (Choice B) could indicate respiratory distress or hypoxia, not improvement in fluid volume status. A decrease in capillary refill time (Choice D) may indicate improved peripheral perfusion but is not a direct indicator of fluid replacement success.

4. A nurse is caring for a client who has terminal lung cancer. The nurse observes the client’s family assisting with all ADLs. Which of the following rationales for self-care should the nurse communicate to the family?

• A. Allowing the client to function independently will strengthen muscles and promote healing.
• B. The client needs privacy at times for self-reflection and organizing life.
• C. The client’s sense of loss can be lessened through retaining control of some areas of life.
• D. Performing ADLs is a requirement prior to discharge from an acute care facility.

Correct answer: C

Rationale: The correct answer is C. In situations like terminal illness, allowing clients to perform activities of daily living (ADLs) can help maintain their sense of control and dignity, providing comfort and a sense of normalcy amidst their health challenges. Choice A is incorrect because in a terminal stage, the focus is not on muscle strength or promoting physical healing but rather on enhancing the client's emotional well-being. Choice B, while highlighting the importance of privacy, is not directly addressing the client's need for control and autonomy. Choice D is incorrect as the priority in this scenario is not related to discharge requirements but rather the client's emotional and psychological needs during their terminal illness.

5. A client admitted with abdominal pain tells the nurse that her father died recently, and she begins crying while talking about him. The nurse determines that the client’s temperature is 39.2°C (102.6°F), her abdomen is soft without tenderness, and her menses are overdue by 2 days. To which observation should the nurse give priority attention?

• A. The client’s temperature
• B. The client’s menses are overdue
• C. The client’s crying
• D. The client’s soft abdomen

Correct answer: B

Rationale: The correct answer is B. An overdue menses might indicate a potential cause of abdominal pain, especially in the context of recent emotional stress. While the client's temperature, crying, and soft abdomen are important observations, the priority should be given to the overdue menses as it could provide crucial information related to the abdominal pain and the client's overall health status. The emotional distress may have a secondary impact on the physical symptoms, making the menstrual status a critical observation to address first.

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