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 providing teaching to a client who was newly diagnosed with nephrotic syndrome. Which of the following statements should indicate to the nurse that the client understands the teaching?

• A. I can expect swelling in my hands and on my face.
• B. The amount of protein in my blood is high.
• C. I might have some pain and gas in my stomach from this condition.
• D. I will use a soft bristle toothbrush to prevent bleeding gums.

Correct answer: A

Rationale: The correct answer is A. Nephrotic syndrome leads to edema, especially of the face and dependent areas, due to the loss of protein in the urine. Choice B is incorrect because nephrotic syndrome leads to protein loss in the urine, not an increase in blood protein levels. Choice C is incorrect as stomach pain and gas are not typical symptoms of nephrotic syndrome. Choice D is incorrect as using a soft bristle toothbrush is not directly related to the manifestations of nephrotic syndrome.

3. What lab value should be prioritized in a patient with HIV?

• A. CD4 T-cell count below 180 cells/mm3
• B. White blood cell count
• C. Serum albumin levels
• D. Hemoglobin levels

Correct answer: A

Rationale: The correct answer is A: CD4 T-cell count below 180 cells/mm3. Monitoring the CD4 T-cell count is crucial in patients with HIV as it indicates the level of immunocompromise. A count below 180 cells/mm3 signifies severe immunocompromise and an increased risk of opportunistic infections. Choices B, C, and D are not the priority lab values in HIV management. While white blood cell count, serum albumin levels, and hemoglobin levels are important, they do not directly reflect the immune status and progression of HIV as the CD4 T-cell count does.

4. What ECG changes are associated with hyperkalemia?

• A. Flattened T waves
• B. ST depression
• C. Prominent U waves
• D. Elevated ST segments

Correct answer: B

Rationale: Hyperkalemia is known to cause ST depression on an ECG. Flattened T waves are more commonly seen in hypokalemia. Prominent U waves are associated with hypokalemia rather than hyperkalemia. Elevated ST segments are not typical findings in hyperkalemia.

5. A nurse is assessing a client who has meningitis. The nurse should identify which of the following findings as a positive Kernig's sign?

• A. After stroking the lateral area of the foot, the client's toes contract and draw together
• B. After hip flexion, the client is unable to extend their leg completely without pain
• C. The client's voluntary movement is not coordinated
• D. The client reports pain and stiffness when flexing their neck

Correct answer: B

Rationale: A positive Kernig's sign is identified when a client is unable to extend their leg completely without pain after hip flexion. This finding suggests meningeal irritation. Choices A, C, and D do not describe Kernig's sign. Choice A describes a normal plantar reflex, Choice C refers to coordination deficits, and Choice D indicates neck pain and stiffness, which are not related to Kernig's sign.

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