Nursing Elites

1. A client is being educated about the use of spironolactone. Which of the following should be included in the teaching?

• A. Avoid potassium-rich foods
• B. Take the medication with food
• C. Monitor for signs of toxicity
• D. Discontinue the medication if potassium levels rise

Correct answer: A

Rationale: The correct answer is A: Avoid potassium-rich foods. Spironolactone can lead to hyperkalemia, a condition characterized by high levels of potassium in the blood. To prevent this complication, clients taking spironolactone should avoid potassium-rich foods. Choice B is incorrect because spironolactone can be taken with or without food. Choice C is not directly related to spironolactone use, as toxicity monitoring is not a specific concern with this medication. Choice D is incorrect because discontinuing the medication solely based on elevated potassium levels may not be necessary; instead, dosage adjustments or potassium restriction are often more appropriate.

2. A healthcare provider is educating a client about the use of montelukast. Which of the following should be included?

• A. It is used for acute asthma attacks
• B. It is taken once daily in the evening
• C. It should be taken with food
• D. It has no side effects

Correct answer: B

Rationale: The correct answer is B. Montelukast is a leukotriene receptor antagonist that is typically taken once daily in the evening for asthma management. Choice A is incorrect as montelukast is not used for acute asthma attacks but rather for the prevention of asthma symptoms. Choice C is also incorrect because montelukast can be taken with or without food. Choice D is misleading as all medications, including montelukast, have potential side effects.

3. A healthcare professional is reviewing the lab report of a client who has been experiencing a fever for the last 3 days. What lab result indicates the client is experiencing fluid volume deficit (FVD)?

• A. Decreased hematocrit
• B. Increased BUN
• C. Increased hematocrit
• D. Decreased urine specific gravity

Correct answer: C

Rationale: An increased hematocrit level indicates dehydration or fluid volume deficit. Hematocrit measures the proportion of blood volume that is occupied by red blood cells, and when a client is experiencing fluid volume deficit, there is less fluid in the blood, causing the concentration of red blood cells to be higher, leading to an increased hematocrit level. Decreased hematocrit (Choice A) is more indicative of fluid volume excess. Increased BUN (Choice B) is associated with renal function and dehydration but is not a direct indicator of FVD. Decreased urine specific gravity (Choice D) is also associated with dehydration, but an increased hematocrit is a more specific indicator of fluid volume deficit.

4. A nurse is reviewing dietary assessment findings for a client who is Jewish and observes kosher dietary practices. Which of the following behaviors should the nurse expect to find?

• A. Leavened bread may be eaten during Passover
• B. Shellfish is commonly consumed in the diet
• C. Meat and dairy products are eaten separately
• D. Fasting from meat occurs during Hanukkah

Correct answer: C

Rationale: The correct answer is C. According to kosher dietary laws, meat and dairy products cannot be consumed together. This practice stems from the prohibition in Jewish law against cooking a young animal in its mother's milk. Therefore, the nurse should expect to find that meat and dairy products are eaten separately. Choices A, B, and D are incorrect. Leavened bread is not eaten during Passover (Choice A), shellfish is not consumed in the kosher diet (Choice B), and fasting from meat does not occur during Hanukkah (Choice D).

5. A nurse is planning care for an adolescent client with chronic renal failure. Which action should the nurse include?

• A. Encourage a diet high in calcium
• B. Provide a diet high in potassium
• C. Ensure increased fluid intake
• D. Restrict protein intake to the RDA

Correct answer: D

Rationale: In chronic renal failure, it is essential to restrict protein intake to the Recommended Dietary Allowance (RDA) to reduce the accumulation of waste products that the kidneys can no longer effectively eliminate. Choices A, B, and C are incorrect because in chronic renal failure, high calcium, high potassium, and increased fluid intake can further strain the kidneys and worsen the condition.

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