Nursing Elites

1. What does oliguria lead to in patients with acute kidney injury?

• A. Hypophosphatemia and overgrowth of bone tissue
• B. An increase in blood potassium levels due to excessive excretion of parathyroid hormone
• C. Sodium retention and elevated levels of potassium
• D. Edema due to increased urine production

Correct answer: C

Rationale: In patients with acute kidney injury, oliguria (reduced urine output) often results in sodium retention and hyperkalemia (elevated levels of potassium). This is due to the kidneys' decreased capacity to excrete these substances. Choice A is incorrect because hypophosphatemia and overgrowth of bone tissue are not direct consequences of oliguria in acute kidney injury. Choice B is incorrect because an increase in blood potassium levels is not caused by excessive excretion of parathyroid hormone but rather by decreased excretion of potassium. Choice D is incorrect because edema is not caused by increased urine production but rather by fluid overload due to decreased urine output.

2. Mr. Bradley has been advised to limit his dairy product intake. What principle regarding fluid intake should be followed?

• A. Gelatin, soups, fruit ices, and frozen fruit bars contribute to your fluid intake
• B. Drink milk in moderation
• C. Increase fiber intake
• D. Limit protein intake

Correct answer: A

Rationale: For patients with kidney disease, it's important to manage fluid intake from all sources, including foods like gelatin and soups, which can contribute to fluid overload.

3. Which of the following interventions should be considered the highest priority when caring for June, who has hemiparesis secondary to a stroke?

• A. Position June in an upright lateral position
• B. Perform range of motion exercises
• C. Apply antiembolic stockings
• D. Use hand rolls or pillows for support

Correct answer: C

Rationale: The correct answer is C, 'Apply antiembolic stockings'. In the case of a patient who has experienced a stroke and is suffering from hemiparesis, the highest priority intervention is to prevent further complications such as deep vein thrombosis (DVT), which can be life-threatening. Antiembolic stockings are used to increase venous blood flow velocity and reduce the risk of DVT. Choice 'A', positioning June in an upright lateral position, while important for overall care, is not the highest priority. Choice 'B', performing range of motion exercises, is an important part of recovery but not the immediate priority. Choice 'D', using hand rolls or pillows for support, is also a valuable intervention but does not address the most pressing risk of further complications.

4. A nurse is teaching a nutrition class for clients who have type 2 diabetes mellitus. Which of the following statements should the nurse include about management of acute illness?

• A. Consume carbs every 3-4 hrs
• B. Decrease fluid intake to 1000 mL per day
• C. Monitor blood glucose twice per day
• D. Check urine for ketones every 24 hrs

Correct answer: A

Rationale: The correct statement is to 'Consume carbs every 3-4 hours.' During acute illness, it is important to maintain a consistent carbohydrate intake to help manage blood glucose levels for clients with type 2 diabetes. This frequent consumption can prevent hypoglycemia and provide energy needed during illness. Decreasing fluid intake (choice B) is not recommended during acute illness, as hydration is crucial to prevent complications. Monitoring blood glucose (choice C) more frequently than twice a day is necessary during acute illness. Checking urine for ketones (choice D) should be done more frequently than once every 24 hours during illness to monitor for diabetic ketoacidosis.

5. A client is being educated by a nurse on snacks suitable for a low-fat, low-sodium, and low-cholesterol diet. Which of the following food choices by the client indicates the need for further teaching?

• A. A slice of cheese
• B. A jam sandwich
• C. A cup of plain popcorn
• D. A small container of applesauce

Correct answer: A

Rationale: The correct answer is A: A slice of cheese. Cheese is high in fat, sodium, and cholesterol, making it unsuitable for a low-fat, low-sodium, and low-cholesterol diet. Choices B, C, and D are more appropriate for such a diet. B: A jam sandwich can be low in fat, sodium, and cholesterol if made with whole grain bread and a low-sugar jam. C: A cup of plain popcorn is a good choice as it is low in fat and can be made without added salt. D: A small container of applesauce is also a suitable option for a low-fat, low-sodium, and low-cholesterol diet.

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