Nursing Elites

1. A client with a new diagnosis of celiac disease is being taught about dietary management. Which of the following statements should be included by the healthcare provider?

• A. You should avoid foods that contain gluten.
• B. You should increase your intake of dairy products.
• C. You should avoid foods that contain lactose.
• D. You should increase your intake of high-fiber foods.

Correct answer: A

Rationale: The correct answer is A: 'You should avoid foods that contain gluten.' Gluten is a protein found in wheat, barley, and rye, which can trigger an immune response in individuals with celiac disease. Avoiding gluten-containing foods is crucial to managing the condition and preventing symptoms and complications associated with celiac disease. Choices B, C, and D are incorrect. Increasing dairy intake (Choice B) is not necessary for celiac disease management. Avoiding lactose (Choice C) is relevant for individuals with lactose intolerance, not celiac disease. While high-fiber foods (Choice D) are generally beneficial for health, they are not specifically indicated for celiac disease management.

2. A client has a prescription for a clear liquid diet. Which of the following foods should the nurse offer?

• A. Milk
• B. Vegetable juice
• C. Chicken broth
• D. Orange juice with pulp

Correct answer: C

Rationale: A clear liquid diet consists of easily digestible transparent liquids. Chicken broth is an appropriate choice as it meets the criteria of being clear and liquid, making it suitable for a clear liquid diet. Milk, vegetable juice, and orange juice with pulp are not considered clear liquids. Milk is not transparent, vegetable juice is not clear, and orange juice with pulp contains solid particles, all of which do not align with the requirements of a clear liquid diet.

3. A client with cirrhosis is being taught about dietary management. Which of the following statements by the client indicates an understanding of the teaching?

• A. I should increase my intake of sodium-rich foods.
• B. I should decrease my intake of sodium-rich foods.
• C. I should increase my intake of potassium-rich foods.
• D. I should decrease my intake of potassium-rich foods.

Correct answer: B

Rationale: The correct answer is B. In cirrhosis, decreasing the intake of sodium-rich foods is essential to manage fluid retention and symptoms. Excessive sodium intake can worsen fluid accumulation and lead to complications such as ascites. Therefore, advising the client to decrease sodium-rich foods demonstrates an understanding of the dietary management necessary for cirrhosis. Choices A, C, and D are incorrect because increasing sodium-rich foods can exacerbate fluid retention and complications in cirrhosis, increasing potassium-rich foods is not the primary focus of dietary management in cirrhosis, and decreasing potassium-rich foods is not a key recommendation for managing cirrhosis-related dietary issues.

4. A client is receiving enteral feedings through an NG tube. Which of the following actions should be taken to prevent aspiration?

• A. Monitor gastric residuals every 4 hours.
• B. Position the client in a semi-Fowler's position.
• C. Check for tube placement by auscultating air after feeding.
• D. Warm the formula to body temperature before feeding.

Correct answer: A

Rationale: Monitoring gastric residuals every 4 hours is essential to assess the stomach's ability to empty properly, reducing the risk of aspiration. It helps in determining if the feedings are being tolerated by the client and if adjustments are needed in the feeding regimen. Positioning the client in a semi-Fowler's position helps prevent reflux and aspiration by promoting proper digestion and emptying of the stomach contents. Checking for tube placement by auscultating air after feeding confirms correct tube placement in the stomach. Warming the formula to body temperature before feeding enhances client comfort but does not directly prevent aspiration. Therefore, the correct answer is to monitor gastric residuals to prevent aspiration, as it directly assesses the stomach's ability to empty properly and the tolerance of the feedings.

5. A healthcare professional is preparing to administer an intramuscular (IM) injection to a client. Which of the following actions should the healthcare professional take?

• A. Use a 1-inch needle.
• B. Insert the needle at a 45-degree angle.
• C. Aspirate before injecting the medication.
• D. Administer the injection in the deltoid muscle.

Correct answer: C

Rationale: Aspirating before injecting the medication is a crucial step in IM injections to check for blood return, ensuring that the needle is not in a blood vessel. This technique helps prevent accidental intravascular injection of the medication, reducing the risk of complications such as inadvertent intravenous administration of the substance.

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