Nursing Elites

1. A client with a new diagnosis of pancreatitis is being taught about dietary management. Which of the following statements should the nurse include in the teaching?

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

Correct answer: B

Rationale: The correct statement the nurse should include in teaching a client with pancreatitis is to decrease the intake of high-fat foods. This dietary modification is crucial in managing symptoms and preventing exacerbations of pancreatitis. High-fat foods can put a strain on the pancreas, potentially leading to further complications. Choice A is incorrect because increasing intake of high-fat foods can worsen pancreatitis. Choice C is unrelated to pancreatitis management, as lactose intolerance is not directly linked to pancreatitis. Choice D is also incorrect, as increasing dairy product intake may not be suitable for all individuals with pancreatitis due to the fat content in many dairy products.

2. A nurse is providing discharge teaching to a client who has a prescription for digoxin. Which of the following instructions should the nurse include?

• A. Take your pulse before taking the medication.
• B. Take the medication with an antacid.
• C. Double the dose if you miss one.
• D. Take the medication with a high-fiber meal.

Correct answer: A

Rationale: The correct answer is A: 'Take your pulse before taking the medication.' When administering digoxin, it is crucial to monitor the pulse rate because digoxin can cause bradycardia (slow heart rate). Checking the pulse helps in assessing the heart rate before taking the medication, as bradycardia is a common side effect of digoxin. Choice B is incorrect because digoxin should not be taken with antacids, as they can reduce its absorption. Choice C is incorrect; the dose should never be doubled if a dose is missed. Choice D is incorrect because taking digoxin with a high-fiber meal can also affect its absorption. Therefore, the essential instruction for the client is to monitor the pulse before taking digoxin.

3. A healthcare provider is caring for a client who has acute renal failure. Which of the following laboratory results should the healthcare provider expect?

• A. Decreased blood urea nitrogen (BUN)
• B. Decreased creatinine
• C. Increased potassium
• D. Increased calcium

Correct answer: C

Rationale: In acute renal failure, the kidneys are unable to excrete potassium efficiently, which can lead to hyperkalemia. As a result, an increased potassium level is a common finding in clients with acute renal failure. Hyperkalemia can have serious cardiac effects, making it essential for healthcare providers to monitor and manage potassium levels closely in clients with renal impairment. Choices A, B, and D are incorrect because in acute renal failure, blood urea nitrogen (BUN) and creatinine levels typically rise due to decreased renal function. Calcium levels are more likely to be decreased in acute renal failure due to impaired activation of vitamin D and subsequent decreased calcium absorption.

4. A client with a new diagnosis of type 1 diabetes mellitus is being taught by a nurse. Which of the following statements should the nurse include in the teaching?

• A. You can still eat sugar, but you must count it in your carbohydrate count for the day.
• B. You need to avoid all forms of sugar to keep your blood glucose levels under control.
• C. You can eat unlimited amounts of proteins and fats since they do not affect blood glucose levels.
• D. You will need to take an oral hypoglycemic agent every day to manage your blood glucose levels.

Correct answer: A

Rationale: The correct statement to include in teaching a client with type 1 diabetes mellitus is that they can still eat sugar, but they must count it in their carbohydrate intake for the day. This is important because clients with type 1 diabetes need to manage their blood glucose levels by calculating their carbohydrate intake, including sugars. Choice B is incorrect because total avoidance of sugar is not necessary, but monitoring and including it in the carbohydrate count is essential. Choice C is incorrect as proteins and fats can also affect blood glucose levels and should be consumed in moderation. Choice D is incorrect since oral hypoglycemic agents are not used in type 1 diabetes mellitus, as insulin replacement therapy is the mainstay of treatment.

5. When caring for a client with a prescription for wound irrigation, which action should the nurse take?

• A. Use a 10-mL syringe with an 18-gauge needle.
• B. Cleanse the wound from the center outward.
• C. Apply a wet-to-dry dressing.
• D. Pack the wound tightly with gauze.

Correct answer: B

Rationale: When caring for a client with a prescription for wound irrigation, the nurse should cleanse the wound from the center outward. This technique helps prevent the introduction of microorganisms into the wound, reducing the risk of contamination and promoting effective wound healing. By using a circular motion from the cleanest area to the least clean areas, debris and bacteria are moved away from the wound site, decreasing the chances of infection.

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