Nursing Elites

1. The nurse is planning care for a 16-year-old with juvenile rheumatoid arthritis (JRA). The nurse includes activities to strengthen and mobilize the joints and surrounding muscles. Which physical therapy regimen should the nurse encourage the adolescent to implement?

• A. Exercise in a swimming pool.
• B. Splint affected joints during activity.
• C. Perform passive range of motion exercises twice daily.
• D. Begin a training program of lifting weights and running.

Correct answer: A

Rationale: Exercising in a swimming pool is beneficial for adolescents with juvenile rheumatoid arthritis as it reduces stress on the joints while allowing movement and strengthening. The buoyancy of water supports the body, making exercises easier and less painful, while also providing resistance to strengthen muscles. This form of exercise can help improve joint mobility and overall function without causing excessive strain on the joints. Choices B, C, and D are incorrect because splinting affected joints, performing passive range of motion exercises, or beginning a training program of lifting weights and running can potentially exacerbate symptoms and cause additional stress on the joints, which is not recommended for individuals with juvenile rheumatoid arthritis.

2. Why is a low-protein diet recommended for a patient with renal failure?

• A. To prevent fluid overload
• B. To reduce nitrogenous waste
• C. To maintain electrolyte balance
• D. To prevent hyperglycemia

Correct answer: B

Rationale: A low-protein diet is crucial for patients with renal failure to reduce the generation of nitrogenous waste products like urea and creatinine, which the compromised kidneys struggle to eliminate effectively. By limiting protein intake, the production of these waste products is decreased, lessening the burden on the kidneys and helping to manage the progression of renal failure. Choices A, C, and D are incorrect because a low-protein diet primarily aims to reduce the workload on the kidneys by decreasing the production of nitrogenous waste, not to prevent fluid overload, maintain electrolyte balance, or prevent hyperglycemia.

3. The client with gastroesophageal reflux disease (GERD) is being taught about dietary modifications by the nurse. Which instruction should the nurse include?

• A. Increase your intake of spicy foods.
• B. Avoid lying down immediately after eating.
• C. Consume a high-fat diet.
• D. Drink caffeinated beverages with meals.

Correct answer: B

Rationale: Avoiding lying down immediately after eating is essential in managing GERD as it helps prevent reflux symptoms by allowing gravity to assist in keeping stomach contents down. Lying down can worsen symptoms by allowing acid to flow back into the esophagus.

4. A patient with hyperthyroidism is to receive radioactive iodine therapy. What information should the nurse include in the patient teaching plan?

• A. Avoid close contact with pregnant women for one week.
• B. Take iodine supplement daily.
• C. Restrict fluid intake to 1 liter per day.
• D. Use disposable utensils for all meals.

Correct answer: A

Rationale: The correct answer is to avoid close contact with pregnant women for one week. This precaution is essential to prevent radiation exposure to vulnerable populations. Pregnant women and small children are more sensitive to radiation, making it crucial for patients undergoing radioactive iodine therapy to avoid close contact with them for a specified period. Choices B, C, and D are incorrect because taking iodine supplements daily is not necessary for patients receiving radioactive iodine therapy. Restricting fluid intake to 1 liter per day is not a standard recommendation for radioactive iodine therapy. Using disposable utensils for all meals is not a specific precaution related to radioactive iodine therapy.

5. When should surgical correction of hypospadias typically occur for a newborn infant as advised by the nurse?

• A. Repair should be done within one month to prevent bladder infections.
• B. Repairs should typically be done before the child is potty-trained.
• C. Delaying the repair until school age reduces castration fears.
• D. To form a proper urethra repair, it should be done after sexual maturity.

Correct answer: B

Rationale: Surgical repair of hypospadias is recommended to be performed before the child is potty-trained to prevent complications. Early correction helps in achieving better outcomes and reduces the risk of issues related to urination and development of the genitalia.

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