Nursing Elites

1. A client is being taught about which foods to include in a low fiber diet. Which statement indicates understanding?

• A. Choosing a fresh pear would be a good snack option
• B. I should make refried beans for supper
• C. Selecting white rice as a side dish is a good choice
• D. Opting for bran cereal would be a good breakfast choice

Correct answer: C

Rationale: The correct answer is C because white rice is a low-fiber food suitable for a low-fiber diet, making it an appropriate choice. Choices A, B, and D are incorrect because fresh pear, refried beans, and bran cereal are high-fiber foods and not suitable for a low-fiber diet.

2. A client has bilateral eye patches following an injury. When the client's food tray arrives, which of the following interventions should the nurse take to promote independence in eating?

• A. Explain to the client that their tray is here and place their hands on it
• B. Ask the client if they would prefer a liquid diet
• C. Assign an assistive personnel to feed the client
• D. Describe to the client the location of the food on the tray

Correct answer: D

Rationale: Describing the location of food on the tray helps promote independence for the client with bilateral eye patches. By providing clear instructions on where the food is placed, the client can independently locate and consume their meal. Option A is incorrect as physically placing the client's hands on the tray does not encourage independence. Option B is unnecessary unless there are specific dietary restrictions indicated. Option C does not promote the client's independence and should be avoided unless absolutely necessary.

3. A client with chronic obstructive pulmonary disease (COPD) is being assessed by a nurse. Which finding indicates the condition is worsening?

• A. Increased shortness of breath
• B. Decreased wheezing
• C. Productive cough with green sputum
• D. Slight increase in fatigue

Correct answer: A

Rationale: The correct answer is A: Increased shortness of breath. In COPD, worsening symptoms often include increased shortness of breath due to impaired lung function. This indicates a decline in respiratory status and the need for prompt intervention. Choice B, decreased wheezing, is not indicative of worsening COPD as it could suggest better airflow. Choice C, productive cough with green sputum, may indicate an infection but not necessarily worsening COPD. Choice D, a slight increase in fatigue, is non-specific and may not directly correlate with the worsening of COPD.

4. When caring for a patient with a nasogastric (NG) tube, what is the most appropriate intervention to prevent aspiration?

• A. Flush the NG tube with water before each feeding.
• B. Check the placement of the NG tube before each feeding.
• C. Elevate the head of the bed to 30-45 degrees.
• D. Provide the patient with oral care every 4 hours.

Correct answer: C

Rationale: Elevating the head of the bed to 30-45 degrees is the most appropriate intervention to prevent aspiration in a patient with an NG tube. This position helps reduce the risk of regurgitation and aspiration by promoting the proper flow of contents through the gastrointestinal tract and minimizing the chances of stomach contents entering the airway. Flushing the NG tube with water before each feeding may not directly prevent aspiration. Checking the placement of the NG tube is important but does not specifically address the prevention of aspiration. Providing oral care every 4 hours is essential for maintaining oral hygiene but is not directly related to preventing aspiration in a patient with an NG tube.

5. A patient with chronic kidney disease has been prescribed a low-protein diet. What is the nurse's priority intervention?

• A. Encourage the patient to eat small, frequent meals.
• B. Monitor the patient's intake and output.
• C. Educate the patient on the benefits of a low-protein diet.
• D. Monitor the patient's protein intake closely.

Correct answer: D

Rationale: The correct answer is to monitor the patient's protein intake closely. In patients with chronic kidney disease on a low-protein diet, monitoring protein intake is crucial to prevent complications such as malnutrition or inadequate nutrient intake. Encouraging small, frequent meals (Choice A) can be beneficial but is not the priority over monitoring protein intake. Monitoring intake and output (Choice B) is important but does not directly address the specific focus on protein intake. Educating the patient on the benefits of a low-protein diet (Choice C) is essential but not as immediate as monitoring the actual protein intake.

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