Nursing Elites

1. A client with pre-dialysis end-stage kidney disease is being taught about diet. Which of the following instructions should the nurse include?

• A. Increase intake of dietary phosphorus.
• B. Eliminate foods high in protein from your diet.
• C. Reduce intake of foods high in potassium.
• D. Increase intake of sodium-containing foods.

Correct answer: C

Rationale: In pre-dialysis end-stage kidney disease, reducing intake of foods high in potassium is crucial as impaired kidney function can lead to potassium buildup in the blood, which can be dangerous. High potassium levels can cause irregular heartbeats and even cardiac arrest. Therefore, advising the client to reduce potassium-rich foods is essential to prevent complications. Choices A, B, and D are incorrect. Increasing dietary phosphorus, eliminating foods high in protein, or increasing sodium-containing foods are not appropriate recommendations for a client with pre-dialysis end-stage kidney disease as they can exacerbate the condition.

2. In which type of shock does the patient experience a mismatch of blood flow to the cells?

• A. Distributive
• B. Cardiogenic
• C. Hypovolemic
• D. Septic

Correct answer: A

Rationale: The correct answer is A: Distributive shock. Distributive shock is characterized by a widespread increase in vascular permeability leading to a relative hypovolemia and a mismatch of blood flow to the cells. Choice B, Cardiogenic shock, is due to the heart's inability to pump effectively. Choice C, Hypovolemic shock, results from a decrease in intravascular volume. Choice D, Septic shock, is caused by a systemic response to infection.

3. The healthcare professional in the dialysis unit understands that patients may experience various complications during hemodialysis. What describes a common complication during hemodialysis?

• A. confusion
• B. profuse sweating
• C. hypertension
• D. leg cramps

Correct answer: D

Rationale: Leg cramps are a common complication during hemodialysis due to shifts in fluid and electrolyte levels that occur during the treatment. Confusion (choice A) is not a common complication specifically related to hemodialysis. Profuse sweating (choice B) is not typically associated with hemodialysis complications. Hypertension (choice C) might be a pre-existing condition in some patients but is not a direct common complication of hemodialysis.

4. What is considered fast breathing in a 13-month-old child if the respiratory rate (RR) exceeds which value?

• A. 40 breaths per minute
• B. 50 breaths per minute
• C. 60 breaths per minute
• D. 30 breaths per minute

Correct answer: C

Rationale: In the context of pediatric care, a respiratory rate of more than 60 breaths per minute in a child aged 13 months is considered fast breathing, hence option 'C' is correct. Options 'A', 'B', and 'D' are incorrect as they do not meet the specified criteria for fast breathing in a 13-month-old. Effective nursing care involves comprehensive assessments that address all aspects of a patient's condition, including monitoring respiratory rates, to ensure that interventions are appropriately targeted and outcomes are optimized.

5. Why might patients with periodontal disease require increased protein intake?

• A. Both the statement and the reason are correct and related
• B. Both the statement and the reason are correct but are not related
• C. The statement is correct, but the reason is not correct
• D. The statement is not correct, but the reason is correct

Correct answer: A

Rationale: Patients with periodontal disease may require increased protein intake due to the physiological response to inflammation and infection, which can negatively impact protein synthesis. Protein is essential for wound healing and tissue repair, and an infection can increase the body's protein requirements. Therefore, ensuring an adequate protein intake is particularly important for these patients. Choice A is correct because the statement and reason are both accurate and directly related to each other, supporting the increased protein needs in patients with periodontal disease. Choices B, C, and D are incorrect as they do not accurately assess the relationship between the statement and the reason provided in the question.

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