Nursing Elites

1. When working with a client who has chronic constipation, what should be included in client teaching to promote normal bowel function?

• A. Use glycerin suppositories on a regular basis
• B. Limit physical activity in order to promote bowel peristalsis
• C. Consume high-residue, high-fiber foods
• D. Resist the urge to defecate until the urge becomes intense

Correct answer: C

Rationale: Consuming high-residue, high-fiber foods is essential in promoting normal bowel function and preventing constipation. These foods help add bulk to the stool, making it easier to pass and preventing constipation. Glycerin suppositories may provide short-term relief but are not a long-term solution for chronic constipation. Physical activity actually helps promote bowel peristalsis, so limiting it would not be beneficial. Delaying defecation can lead to stool hardening and worsening constipation.

2. A patient with heart failure is prescribed digoxin. What is the most important instruction the nurse should provide?

• A. Take an extra dose if you miss one.
• B. Avoid high-potassium foods.
• C. Report any visual disturbances.
• D. Stop taking the medication if your pulse is normal.

Correct answer: C

Rationale: The correct answer is C: 'Report any visual disturbances.' Patients taking digoxin should be instructed to report any visual disturbances, as this can be a sign of digoxin toxicity. Visual disturbances like changes in color vision, blurred vision, or seeing halos around lights can indicate an overdose of digoxin. Choices A, B, and D are incorrect. Instructing a patient to take an extra dose if they miss one can lead to overdose. Avoiding high-potassium foods is important for patients on potassium-sparing diuretics, not digoxin. Stopping the medication if the pulse is normal is incorrect, as the pulse rate alone is not an indicator of digoxin effectiveness or toxicity.

3. A healthcare provider is providing dietary teaching to a client with cholecystitis. Which type of diet should the healthcare provider recommend?

• A. High-fiber, low-fat diet
• B. Low-fiber, high-protein diet
• C. Low-fat, low-cholesterol diet
• D. High-protein, high-fat diet

Correct answer: C

Rationale: In cholecystitis, a low-fat, low-cholesterol diet is recommended to manage symptoms and reduce inflammation by reducing the workload on the gallbladder. This diet helps prevent gallbladder attacks and complications.

4. What action should the nurse take to prevent tracheal tissue damage in a client with a tracheostomy?

• A. Secure the tracheostomy ties firmly.
• B. Change the tracheostomy tube daily.
• C. Use the minimal leak technique when inflating the cuff.
• D. Clean the stoma with hydrogen peroxide.

Correct answer: C

Rationale: To prevent tracheal tissue damage in a client with a tracheostomy, the nurse should use the minimal leak technique when inflating the cuff. This method helps avoid excessive pressure on the tracheal tissue, thereby reducing the risk of damage. Choice A is incorrect because securing the tracheostomy ties too tightly can cause pressure and tissue damage. Choice B is incorrect as changing the tracheostomy tube daily is not necessary unless there is a specific clinical indication. Choice D is incorrect as cleaning the stoma with hydrogen peroxide can irritate the skin and mucous membranes, potentially leading to damage.

5. A patient with rheumatoid arthritis is prescribed methotrexate. What is an important teaching point for the nurse to provide?

• A. Take folic acid supplements as prescribed.
• B. Avoid alcohol completely.
• C. Expect to see immediate results.
• D. Limit fluid intake to 1 liter per day.

Correct answer: A

Rationale: The correct teaching point for a patient prescribed methotrexate is to take folic acid supplements as prescribed. Methotrexate can lead to a folate deficiency, which is why supplementing with folic acid is essential to reduce the risk of side effects such as mouth sores, nausea, and liver problems.

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