Nursing Elites

1. How should a healthcare professional assess and manage a patient with acute renal failure?

• A. Monitor urine output and administer diuretics
• B. Administer IV fluids and restrict potassium intake
• C. Monitor electrolyte levels and provide dietary education
• D. Administer potassium and restrict fluids

Correct answer: A

Rationale: In acute renal failure, it is crucial to monitor urine output to assess kidney function and fluid balance. Administering diuretics helps manage fluid levels by promoting urine production. Choice B is incorrect because administering IV fluids can worsen fluid overload in renal failure patients, and restricting potassium intake is not typically the initial approach. Choice C is not the primary intervention but is important for long-term management. Choice D is incorrect as administering potassium can be dangerous in renal failure, and restricting fluids can lead to dehydration.

2. What is the best dietary recommendation for a patient with chronic kidney disease?

• A. Low-protein diet
• B. High-protein diet
• C. Low-sodium diet
• D. High-sodium diet

Correct answer: A

Rationale: The correct answer is a low-protein diet for a patient with chronic kidney disease. In chronic kidney disease, the kidneys may have difficulty filtering waste products from protein metabolism, leading to a buildup of toxins in the body. Therefore, reducing protein intake can help lessen the workload on the kidneys. Choices B, C, and D are incorrect. A high-protein diet would increase the workload on the kidneys, while a low-sodium diet is beneficial for conditions like hypertension or heart failure but not specifically targeted for chronic kidney disease. A high-sodium diet can worsen fluid retention and hypertension in patients with kidney disease.

3. A nurse is reviewing the plan of care for a client who is receiving chemotherapy for cancer. Which of the following interventions should the nurse include to prevent infection?

• A. Encourage the client to eat high-protein foods
• B. Encourage the client to drink 2 liters of fluid daily
• C. Instruct the client to use a soft toothbrush
• D. Instruct the client to use a mouthwash containing alcohol

Correct answer: C

Rationale: The correct answer is to instruct the client to use a soft toothbrush. Using a soft toothbrush helps prevent bleeding in clients receiving chemotherapy, who are at risk for mucositis. Encouraging the client to eat high-protein foods (Choice A) is important for overall health but not directly related to preventing infection. Encouraging the client to drink 2 liters of fluid daily (Choice B) is essential for hydration but does not specifically prevent infection. Instructing the client to use a mouthwash containing alcohol (Choice D) is contraindicated as alcohol-containing mouthwashes can cause irritation and dryness in the oral mucosa, increasing the risk of infection.

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

• A. Administer the medication into the client's nondominant arm.
• B. Pull the skin laterally before inserting the needle.
• C. Massage the injection site after administration.
• D. Pinch the skin between the thumb and forefinger.

Correct answer: D

Rationale: The correct action the nurse should take when administering enoxaparin subcutaneously is to pinch the skin between the thumb and forefinger. Pinching the skin helps to lift the subcutaneous tissue, reducing the risk of injecting into the muscle. Choices A, B, and C are incorrect. Choice A is not relevant as the injection site for enoxaparin is typically in the abdomen or thigh, not the arm. Choice B is incorrect as pulling the skin laterally is not a recommended technique for subcutaneous injections. Choice C is also incorrect as massaging the injection site after administration can increase the risk of bleeding or bruising.

5. A client with a new diagnosis of type 2 diabetes mellitus inquires about information concerning oral antidiabetic agents. In addition to the provider, where should the nurse refer the client for information?

• A. Family members
• B. Pharmacist
• C. Dietitian
• D. American Diabetes Association

Correct answer: D

Rationale: The correct answer is D: American Diabetes Association. The American Diabetes Association is a reputable source that provides credible information on managing diabetes. While family members can offer support, they may not have the specialized knowledge on oral antidiabetic agents. Pharmacists are knowledgeable about medications but may not provide comprehensive information on diabetes management. Dietitians can offer valuable advice on nutrition but may not cover specific details about oral antidiabetic agents. Therefore, referring the client to the American Diabetes Association ensures access to accurate and detailed information related to their condition.

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