Nursing Elites

1. What dietary recommendations should a patient with GERD follow?

• A. Avoid mint and spicy foods
• B. Consume liquids between meals
• C. Eat three large meals per day
• D. Drink milk as a snack

Correct answer: A

Rationale: Patients with GERD should follow dietary recommendations to manage their symptoms effectively. Choice A, 'Avoid mint and spicy foods,' is the correct answer. Mint and spicy foods can trigger acid reflux and worsen GERD symptoms. Choice B, 'Consume liquids between meals,' is not the best recommendation as consuming liquids during meals can worsen GERD symptoms by increasing stomach pressure. Choice C, 'Eat three large meals per day,' is incorrect as large meals can exacerbate GERD symptoms; instead, smaller, more frequent meals are recommended. Choice D, 'Drink milk as a snack,' is not ideal as full-fat dairy products like milk can trigger acid reflux in some individuals. Therefore, the best recommendation for a patient with GERD is to avoid mint and spicy foods.

2. What are the adverse effects of radiation after a mastectomy?

• A. S3 heart sound, fatigue
• B. Pulselessness in the affected extremity
• C. SOB and JVD
• D. Localized pain, swelling, erythema

Correct answer: A

Rationale: The correct answer is A: S3 heart sound, fatigue. Radiation after a mastectomy can lead to fatigue and symptoms of heart failure, such as the presence of an S3 heart sound. Choices B, C, and D are incorrect. Pulselessness in the affected extremity would be more relevant to vascular complications, shortness of breath (SOB) and jugular venous distention (JVD) could indicate cardiac or respiratory issues unrelated to radiation, and localized pain, swelling, and erythema are more characteristic of a local inflammatory response rather than the systemic effects of radiation post-mastectomy.

3. What ECG changes are expected in hypokalemia?

• A. Flattened T waves on ECG
• B. Prominent U waves on ECG
• C. Widened QRS complexes on ECG
• D. ST elevation on ECG

Correct answer: A

Rationale: In hypokalemia, flattened T waves are a common ECG finding due to the decreased extracellular potassium affecting repolarization. Prominent U waves are typically seen in hypokalemia as well, but flattened T waves are the more specific and early ECG change. Widened QRS complexes are associated with hyperkalemia, not hypokalemia. ST elevation is often seen in conditions like myocardial infarction, pericarditis, or early repolarization syndrome, not specifically in hypokalemia.

4. A healthcare provider is assessing a client who reports a possible exposure to HIV. Which of the following findings should the healthcare provider identify as an early manifestation of HIV infection?

• A. Stomatitis
• B. Fatigue
• C. Wasting syndrome
• D. Lipodystrophy

Correct answer: B

Rationale: The correct answer is 'B: Fatigue.' Early manifestations of HIV infection often include symptoms like fatigue, fever, and rash, which are typical of viral infections. Stomatitis (choice A) refers to inflammation of the mouth and lips, which can occur in HIV but is not specific to early infection. Wasting syndrome (choice C) and lipodystrophy (choice D) are more commonly associated with later stages of HIV infection rather than early manifestations.

5. A nurse is planning care for a group of postoperative clients. Which of the following interventions should the nurse identify as the priority?

• A. Administer IV pain medication to a client who reports pain as a 6 on a scale of 0 to 10
• B. Administer oxygen to a client who has an oxygen saturation of 91%
• C. Instruct a client who is 1 hr postoperative about coughing and deep breathing exercises
• D. Initiate an infusion of 0.9% sodium chloride for a client who has just had abdominal surgery

Correct answer: B

Rationale: The priority intervention is administering oxygen. Postoperatively, the client's oxygen saturation should be at or above 95%. Oxygen is essential for tissue perfusion and cellular oxygenation. While managing pain is important, oxygenation takes precedence. Instructing a client about coughing and deep breathing exercises is important for preventing respiratory complications but is not as urgent as addressing low oxygen saturation. Initiating an infusion of 0.9% sodium chloride is a routine postoperative intervention for fluid balance but is not the priority when oxygen saturation is low.

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