Nursing Elites

1. A client has a new diagnosis of gout, and the nurse is providing dietary management education. Which of the following statements should the nurse include in the teaching?

• A. You should increase your intake of purine-rich foods.
• B. You should decrease your intake of purine-rich foods.
• C. You should avoid foods that contain lactose.
• D. You should increase your intake of dairy products.

Correct answer: B

Rationale: The correct answer is to decrease intake of purine-rich foods to manage uric acid levels and symptoms of gout. Purine-rich foods can exacerbate gout symptoms by increasing uric acid production, leading to flare-ups. Therefore, reducing purine intake is essential in the dietary management of gout. Option A is incorrect because increasing purine-rich foods can worsen gout symptoms. Option C is irrelevant as lactose is not directly related to gout. Option D is incorrect as increasing dairy products is not a recommended dietary modification for managing gout.

2. A client has a prescription for a 24-hour urine collection. Which of the following actions should be taken by the healthcare provider?

• A. Discard the first voiding.
• B. Keep the urine at room temperature.
• C. Collect the first voiding.
• D. Keep the urine in a sterile container.

Correct answer: A

Rationale: Discarding the first voiding is necessary when initiating a 24-hour urine collection to ensure that the collection starts with an empty bladder. This step helps in obtaining an accurate measurement of substances excreted over the 24-hour period without any carryover from the previous voids. Keeping the urine at room temperature or in a sterile container is not specific to the initiation of the collection. Therefore, the correct action is to discard the first voiding. Choice B is incorrect because keeping urine at room temperature is important for some tests, but it is not specific to the initiation of a 24-hour urine collection. Choice C is incorrect because collecting the first voiding would lead to inaccurate results as the bladder is not empty at the start. Choice D is incorrect because while keeping urine in a sterile container is generally a good practice, it is not a specific step for initiating a 24-hour urine collection.

3. A client with renal calculi 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 calcium-rich foods.
• B. I should decrease my intake of calcium-rich foods.
• C. I should increase my intake of sodium-rich foods.
• D. I should decrease my intake of potassium-rich foods.

Correct answer: B

Rationale: The correct answer is B because decreasing the intake of calcium-rich foods can help manage and prevent the formation of renal calculi. Excessive calcium intake can contribute to the formation of these stones, so reducing calcium-rich foods is a key dietary modification for individuals with renal calculi. Choice A is incorrect as increasing calcium-rich foods can exacerbate the condition. Choice C is incorrect because increasing sodium-rich foods can lead to more stone formation due to increased calcium excretion. Choice D is incorrect as potassium-rich foods do not directly contribute to the formation of renal calculi.

4. A healthcare professional is assessing a client who has fluid volume overload. Which of the following findings should the healthcare professional expect?

• A. Hypotension.
• B. Bradycardia.
• C. Crackles in the lungs.
• D. Flat neck veins.

Correct answer: C

Rationale: Crackles in the lungs are a classic sign of fluid volume overload. When there is an excess of fluid in the lungs, it can manifest as crackling sounds upon auscultation. This finding indicates the accumulation of fluid in the alveoli and interstitial spaces of the lungs, which is a common manifestation of fluid volume overload.

5. A client with gout 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 purine-rich foods.
• B. I should decrease my intake of purine-rich foods.
• C. I should increase my intake of sodium-rich foods.
• D. I should decrease my intake of potassium-rich foods.

Correct answer: B

Rationale: The correct answer is B. Decreasing the intake of purine-rich foods is essential in managing gout as purines break down into uric acid, contributing to gout symptoms. Increasing purine-rich foods would exacerbate the condition by increasing uric acid levels. Therefore, choice A is incorrect. Choices C and D are also incorrect as increasing sodium-rich foods (choice C) is not recommended for gout management, and decreasing potassium-rich foods (choice D) is unrelated to gout.

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