Nursing Elites

1. A patient with GERD is being taught by a nurse. What should the patient avoid?

• A. Avoid mint and pepper
• B. Increase water intake during meals
• C. Eat frequent small meals
• D. Consume more spicy foods

Correct answer: A

Rationale: Patients with GERD should avoid mint and spicy foods as they can trigger reflux. Choice B ('Increase water intake during meals') is not recommended for GERD patients as it can worsen symptoms by distending the stomach. Choice C ('Eat frequent small meals') is beneficial for GERD patients to prevent excessive stomach distension. Choice D ('Consume more spicy foods') is incorrect as spicy foods can exacerbate GERD symptoms.

2. What are the manifestations of osteomyelitis?

• A. Localized pain, swelling, erythema
• B. Elevated white blood cells
• C. Elevated calcium levels
• D. Low potassium levels

Correct answer: A

Rationale: Osteomyelitis often manifests as localized pain, swelling, and erythema due to infection in the bone. These symptoms are characteristic of inflammation and infection in the bone tissue. Elevated white blood cells (Choice B) may be present as part of the body's immune response to the infection but are not specific manifestations of osteomyelitis. Elevated calcium levels (Choice C) and low potassium levels (Choice D) are not typically associated with osteomyelitis.

3. What dietary recommendations should be given to a patient with pre-dialysis end-stage kidney disease?

• A. Reduce phosphorus intake to 700 mg/day
• B. Increase sodium intake
• C. Increase protein intake
• D. Increase potassium intake

Correct answer: A

Rationale: The correct recommendation for a patient with pre-dialysis end-stage kidney disease is to reduce phosphorus intake to 700 mg/day. High phosphorus levels can lead to complications in such patients. Increasing sodium intake (Choice B) is generally not recommended due to its association with hypertension and fluid retention. While protein is essential, increasing protein intake (Choice C) in kidney disease can be harmful as it can lead to increased waste products that the kidneys may struggle to excrete. Increasing potassium intake (Choice D) is not advisable as well, as patients with kidney disease may already have difficulty excreting potassium, leading to hyperkalemia.

4. What intervention is needed for continuous bubbling in the chest tube water seal chamber?

• A. Tighten the connections of the chest tube system
• B. Clamp the chest tube
• C. Replace the chest tube system
• D. Continue monitoring the chest tube

Correct answer: A

Rationale: The correct intervention for continuous bubbling in the chest tube water seal chamber is to tighten the connections of the chest tube system. Continuous bubbling indicates an air leak in the system, and tightening the connections can help resolve this issue. Clamping the chest tube (Choice B) is not appropriate and can lead to complications by obstructing the drainage system. Similarly, replacing the entire chest tube system (Choice C) may not be necessary if the issue can be resolved by tightening the connections. Continuing to monitor the chest tube (Choice D) without taking action to address the continuous bubbling may delay necessary interventions to prevent complications.

5. After a healthcare provider misreads a glucose level and administers insulin, what is the priority intervention?

• A. Monitor for hypoglycemia
• B. Administer glucose IV
• C. Document the incident
• D. Monitor for hyperglycemia

Correct answer: A

Rationale: The correct answer is to monitor for hypoglycemia. Administering insulin based on a misread glucose level can lead to hypoglycemia. Monitoring for hypoglycemia is crucial as it is a potential adverse effect of the insulin administration. Administering glucose IV (Choice B) is not the priority as there is no indication of hypoglycemia yet. Documenting the incident (Choice C) is important but not the immediate priority over patient safety. Monitoring for hyperglycemia (Choice D) is not the priority after administering insulin in response to a misread glucose level.

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