Nursing Elites

1. A patient with chronic kidney disease has been prescribed a low-protein diet. What is the nurse's priority intervention?

• A. Encourage the patient to eat small, frequent meals.
• B. Monitor the patient's intake and output.
• C. Educate the patient on the benefits of a low-protein diet.
• D. Monitor the patient's protein intake closely.

Correct answer: D

Rationale: The correct answer is to monitor the patient's protein intake closely. In patients with chronic kidney disease on a low-protein diet, monitoring protein intake is crucial to prevent complications such as malnutrition or inadequate nutrient intake. Encouraging small, frequent meals (Choice A) can be beneficial but is not the priority over monitoring protein intake. Monitoring intake and output (Choice B) is important but does not directly address the specific focus on protein intake. Educating the patient on the benefits of a low-protein diet (Choice C) is essential but not as immediate as monitoring the actual protein intake.

2. A nurse is teaching an older adult client who has left-sided weakness about cane use. Which of the following instructions should the nurse include?

• A. Hold the cane with your left hand
• B. Move the cane forward 18 inches with each step
• C. When walking, move your left foot forward first
• D. Keep your elbow straight when you hold the cane

Correct answer: C

Rationale: The correct instruction for a client with left-sided weakness using a cane is to move the left foot forward first. This technique helps improve stability and safety by ensuring weight-bearing on the stronger side while providing support with the cane. Choice A is incorrect because the cane should be held on the stronger side, which is the right side in this case. Choice B is incorrect as the recommended distance to move the cane forward with each step is about 6 inches, not 18 inches. Choice D is incorrect as it is essential to maintain a slight bend in the elbow while using the cane to absorb shock and provide flexibility.

3. A nurse is preparing to administer enoxaparin subcutaneously to a client. Which of the following actions should the nurse take?

• A. Inject at a 90-degree angle
• B. Inject at a 45-degree angle
• C. Massage the injection site after administering
• D. Use a longer needle

Correct answer: B

Rationale: The correct answer is to inject enoxaparin subcutaneously at a 45-degree angle. This angle helps ensure proper delivery of the medication into the subcutaneous tissue. Option A (Inject at a 90-degree angle) is incorrect because subcutaneous injections are usually given at a shallower angle. Option C (Massage the injection site after administering) is incorrect as massaging the site can cause bruising and should generally be avoided. Option D (Use a longer needle) is incorrect as using a longer needle is unnecessary and may increase the risk of injecting the medication too deeply.

4. A nurse is preparing to perform a 12-lead electrocardiogram (ECG). Which of the following instructions should the nurse provide to the client?

• A. Remain still once the gel pads are attached
• B. I will be placing electrodes on your chest
• C. I will lower the head of your bed so you can sit up
• D. Breathe normally throughout the procedure

Correct answer: A

Rationale: The correct answer is A. Instructing the client to remain still once the gel pads are attached is crucial to obtaining accurate ECG readings. Choice B is incorrect as electrodes are typically placed on the chest, not the breast. Choice C is incorrect because the client should lie flat during an ECG, not sit up. Choice D is incorrect because the client should breathe normally, rather than holding their breath, throughout the procedure.

5. A nurse notices another nurse skipping hand hygiene. What is the appropriate course of action?

• A. Ignore the situation to maintain team harmony.
• B. Report the behavior to the supervisor.
• C. Discuss the issue with the nurse directly.
• D. Do nothing and continue with patient care.

Correct answer: B

Rationale: Correct hand hygiene is crucial for preventing the spread of infections and ensuring patient safety. When a nurse observes another healthcare worker skipping hand hygiene practices, it is essential to report this behavior to the supervisor. Reporting ensures that appropriate action is taken to address the issue and maintain a safe environment for patients. Ignoring the situation (Choice A) may compromise patient safety. Discussing the issue directly with the nurse (Choice C) may not always be effective in ensuring compliance. Doing nothing and continuing with patient care (Choice D) disregards the importance of infection control protocols.

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