Nursing Elites

1. A client has a new diagnosis of hypothyroidism, and a 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 iodine-rich foods.
• B. You should decrease your intake of iodine-rich foods.
• C. You should avoid foods that contain lactose.
• D. You should increase your intake of dairy products.

Correct answer: A

Rationale: In hypothyroidism, increasing intake of iodine-rich foods is beneficial as iodine is essential for the production of thyroid hormones. This helps to support thyroid function in individuals with hypothyroidism. Therefore, advising the client to increase their intake of iodine-rich foods aligns with the recommended dietary management for hypothyroidism. Choice B is incorrect because decreasing iodine-rich foods could lead to further deficiency in individuals with hypothyroidism. Choice C is not directly related to hypothyroidism and lactose intolerance is a separate issue. Choice D is incorrect as increasing dairy products is not a specific recommendation for hypothyroidism unless the client has a deficiency of calcium or vitamin D, which should be assessed separately.

2. When should discharge planning begin for a client admitted to a long-term care facility for rehabilitation after a total hip arthroplasty?

• A. One week prior to the client's discharge
• B. Upon the client's admission to the care facility
• C. Once the discharge date is identified
• D. When the client addresses the topic with the nurse

Correct answer: B

Rationale: Discharge planning should begin upon the client's admission to the care facility. This early start allows the healthcare team to conduct assessments, set goals, and coordinate services for a smooth transition back home or to the community. Initiating discharge planning early ensures timely arrangements, leading to optimal outcomes and continuity of care. Choices A, C, and D are incorrect because waiting until one week before discharge, after the discharge date is identified, or until the client brings up the topic may lead to rushed decision-making, inadequate arrangements, and a less effective transition process.

3. A client has a new diagnosis of renal calculi, and the nurse is teaching about dietary management. Which of the following statements should the nurse include in the teaching?

• A. You should increase your intake of calcium-rich foods.
• B. You should decrease your intake of calcium-rich foods.
• C. You should increase your intake of sodium-rich foods.
• D. You should decrease your intake of potassium-rich foods.

Correct answer: B

Rationale: The correct answer is to decrease the intake of calcium-rich foods when managing renal calculi. Calcium can contribute to the formation of stones in the kidneys, so reducing its intake can help prevent the development of new calculi and manage existing ones.

4. A client has a new prescription for total parenteral nutrition (TPN). Which of the following actions should the nurse plan to take?

• A. Obtain a random blood glucose daily.
• B. Change the IV tubing every 72 hours.
• C. Apply a new dressing to the IV site every 24 hours.
• D. Weigh the client weekly.

Correct answer: A

Rationale: When a client is on total parenteral nutrition (TPN), monitoring blood glucose levels daily is crucial to manage and detect complications like hyperglycemia, which can occur due to the high glucose content in TPN solutions. Regular blood glucose monitoring helps the healthcare team adjust the TPN infusion rate to maintain optimal glucose levels and prevent adverse events. Choices B, C, and D are incorrect because changing IV tubing every 72 hours, applying a new dressing to the IV site every 24 hours, and weighing the client weekly are not specific actions directly related to monitoring and managing the effects of TPN, particularly in relation to glucose levels.

5. A client with lactose intolerance is being taught about dietary management by a nurse. Which statement by the client shows an understanding of the teaching?

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

Correct answer: A

Rationale: The correct answer is A: 'I should avoid foods that contain lactose.' Lactose intolerance results from the inability to digest lactose, a sugar found in dairy products. Avoiding foods that contain lactose is essential in managing symptoms like bloating, diarrhea, and abdominal pain. Choice B is incorrect because increasing dairy intake would worsen symptoms. Choice C is incorrect because gluten is unrelated to lactose intolerance. Choice D is incorrect because high-fiber foods are beneficial for other conditions but do not specifically address lactose intolerance.

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