Nursing Elites

1. During a teaching session on dietary management for heart failure, a client makes a statement. Which of the following statements by the client indicates an understanding of the teaching?

• A. I should increase my intake of foods high in sodium.
• B. I should increase my intake of foods high in potassium.
• C. I should decrease my intake of fluids.
• D. I should decrease my intake of fiber.

Correct answer: C

Rationale: The correct answer is C because decreasing fluid intake is essential in managing fluid retention and symptoms of heart failure. Restricting fluids helps prevent excessive fluid buildup in the body, thus reducing the workload on the heart and alleviating symptoms like swelling and shortness of breath. Choices A, B, and D are incorrect. Increasing intake of foods high in sodium can exacerbate fluid retention and worsen heart failure symptoms. Increasing potassium-rich foods is beneficial for some heart conditions but not heart failure specifically. Decreasing fiber intake is not a standard recommendation for heart failure management.

2. A client is receiving continuous enteral feedings through a nasogastric tube. Which of the following actions should the nurse take?

• A. Elevate the head of the bed to 30°
• B. Flush the tube with 50 mL of water every 2 hours
• C. Replace the feeding bag and tubing every 72 hours
• D. Check the client's gastric residual every 8 hours

Correct answer: A

Rationale: Elevating the head of the bed to 30° is the correct action to take when a client is receiving continuous enteral feedings through a nasogastric tube. This position helps prevent aspiration of the enteral feedings into the lungs, reducing the risk of aspiration pneumonia. Additionally, elevating the head of the bed promotes proper digestion and absorption of the feedings by utilizing gravity to facilitate movement into the stomach and through the gastrointestinal tract. Flushing the tube with water every 2 hours (Choice B) is not necessary for continuous feedings and may disrupt the feeding schedule. Replacing the feeding bag and tubing every 72 hours (Choice C) is not the standard recommendation unless there are specific concerns or complications. Checking the client's gastric residual every 8 hours (Choice D) is important but not the immediate action needed to prevent aspiration during enteral feedings.

3. A healthcare professional is preparing to administer medications to a client who has an NG tube for continuous feedings. Which of the following actions should the healthcare professional take?

• A. Add crushed medications to the enteral feeding.
• B. Infuse each medication by gravity.
• C. Administer the medications through a syringe.
• D. Flush the NG tube with 5 mL of sterile water.

Correct answer: C

Rationale: Administering medications through a syringe is the correct action to take when a client has an NG tube for continuous feedings. This method ensures that each medication is delivered correctly and is not mixed with the enteral feeding, preventing drug interactions and ensuring proper administration of each medication. Adding crushed medications to the enteral feeding (Choice A) can lead to inaccurate dosing and potential drug interactions. Infusing each medication by gravity (Choice B) is not recommended as it may not ensure accurate delivery of the medication. Flushing the NG tube with sterile water (Choice D) is important but is not directly related to administering medications through the tube.

4. 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.

5. A client has a new prescription for a low-fat diet. Which of the following foods should be recommended?

• A. Bacon
• B. Whole milk
• C. Chicken breast
• D. Cheese

Correct answer: C

Rationale: When following a low-fat diet, it is essential to choose foods that are low in fat. Chicken breast is a lean protein source that is low in fat, making it a suitable option for a low-fat diet. Bacon, whole milk, and cheese are higher in fat content and should be avoided or limited in a low-fat diet. Bacon is high in saturated fat, whole milk contains significant amounts of fat, including saturated fat, and cheese is also high in fat. Therefore, these options are not ideal for a low-fat diet.

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