Nursing Elites

1. What dietary instructions should be provided for a patient with pre-dialysis end-stage kidney disease?

• A. Limit phosphorus intake to 700 mg/day
• B. Increase protein intake to 1g/kg/day
• C. Increase sodium intake
• D. Avoid potassium-rich foods

Correct answer: A

Rationale: Patients with pre-dialysis end-stage kidney disease should limit phosphorus intake to manage their condition. Excessive phosphorus can lead to mineral and bone disorders in patients with kidney disease. Choices B, C, and D are incorrect. Increasing protein intake is not recommended as it can burden the kidneys. Increasing sodium intake is usually discouraged due to its association with hypertension and fluid retention in kidney disease. Avoiding potassium-rich foods is more relevant in advanced kidney disease stages when potassium levels are high, not in pre-dialysis end-stage kidney disease.

2. A nurse is caring for a client who has a new diagnosis of tuberculosis. Which of the following precautions should the nurse initiate to prevent transmission of the disease?

• A. Contact precautions
• B. Airborne precautions
• C. Droplet precautions
• D. Protective environment

Correct answer: B

Rationale: Tuberculosis is spread through small droplets measuring less than 5 microns, which can remain airborne for extended periods. The nurse should place a client who has TB under airborne precautions to prevent the spread of microbes. Choice A, contact precautions, are used for diseases spread by direct or indirect contact. Choice C, droplet precautions, are for diseases spread by larger droplets. Choice D, protective environment, is used for immunocompromised clients to protect them from environmental pathogens.

3. What dietary recommendation should be given to a patient with pre-dialysis end-stage kidney disease?

• A. Limit phosphorus intake to 700 mg/day
• B. Increase sodium intake
• C. Restrict protein intake to 0.55-0.60 g/kg/day
• D. Eat three large meals per day

Correct answer: A

Rationale: The correct dietary recommendation for a patient with pre-dialysis end-stage kidney disease is to limit phosphorus intake to 700 mg/day. Excess phosphorus can be harmful to individuals with kidney disease as their kidneys are not able to remove it effectively. Choice B is incorrect as increasing sodium intake is generally not recommended for individuals with kidney disease due to its association with high blood pressure. Choice C is also incorrect as protein restriction is a common recommendation for patients with advanced kidney disease, but the range provided is not accurate. Choice D is incorrect as eating three large meals per day may not be suitable for managing the condition.

4. What are the dietary recommendations for a patient with pre-dialysis end-stage kidney disease?

• A. Reduce phosphorus intake to 700 mg/day
• B. Limit sodium intake to 1,500 mg/day
• C. Restrict protein intake to 0.55-0.60 g/kg/day
• D. Increase protein intake

Correct answer: A

Rationale: The correct recommendation for a patient with pre-dialysis end-stage kidney disease is to reduce phosphorus intake to 700 mg/day. High phosphorus levels can be harmful to individuals with kidney disease as the kidneys may not be able to filter it effectively. While limiting sodium intake to 1,500 mg/day and restricting protein intake to 0.55-0.60 g/kg/day are important in managing kidney disease, the primary concern for this patient population is to control phosphorus levels. Increasing protein intake is not recommended as it can put additional strain on the kidneys. Therefore, option A is the most appropriate recommendation in this scenario.

5. A patient who received an enema reports abdominal cramping. What should the nurse do?

• A. Increase the flow of the enema solution
• B. Lower the height of the enema solution container
• C. Remove the enema tubing
• D. Stop the procedure

Correct answer: B

Rationale: When a patient who received an enema reports abdominal cramping, the nurse should lower the height of the enema solution container. This adjustment can help reduce the cramping by slowing down the flow of the solution into the colon, allowing the patient to tolerate the procedure better. Increasing the flow of the solution (Choice A) can exacerbate the cramping. Removing the enema tubing (Choice C) or stopping the procedure (Choice D) may not address the issue and could lead to incomplete treatment.

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