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. When providing discharge teaching to a patient who underwent cataract surgery, what should the patient avoid?

• A. Avoid NSAIDs
• B. Avoid bright lights
• C. Avoid alcohol
• D. Avoid phosphorus-rich foods

Correct answer: A

Rationale: The correct answer is to avoid NSAIDs. Nonsteroidal anti-inflammatory drugs (NSAIDs) can increase the risk of bleeding after cataract surgery due to their anticoagulant properties. Bright lights (choice B) are not contraindicated post-cataract surgery unless the patient experiences discomfort or sensitivity. Alcohol consumption (choice C) is generally not restricted after cataract surgery, but moderation is recommended. Phosphorus-rich foods (choice D) are not directly related to cataract surgery postoperative care.

3. What signs indicate increased intracranial pressure (IICP)?

• A. Restlessness, irritability, and confusion
• B. Sudden onset of seizures
• C. Bradycardia and altered pupil response
• D. Loss of consciousness

Correct answer: A

Rationale: Restlessness, irritability, and confusion are early signs of increased intracranial pressure (IICP). These symptoms occur due to the brain's increased pressure within the skull. Sudden onset of seizures (Choice B) is not typically associated with increased intracranial pressure. Bradycardia and altered pupil response (Choice C) are signs of advanced or worsening IICP. Loss of consciousness (Choice D) is a late sign of increased intracranial pressure.

4. The nurse misread a patient's glucose as 210 mg/dL instead of 120 mg/dL and administered the insulin dose for a reading over 200 mg/dL. What is the priority action?

• A. Administer glucose IV
• B. Monitor for hyperglycemia
• C. Monitor for hypoglycemia
• D. Document the incident

Correct answer: C

Rationale: The priority action is to monitor the patient for signs of hypoglycemia as the nurse administered excess insulin due to misreading the glucose level. Administering glucose IV (Choice A) is not the immediate priority when dealing with hypoglycemia. Monitoring for hyperglycemia (Choice B) is not the correct action as the insulin was administered for a higher glucose reading. Documenting the incident (Choice D) is important but not the priority when the patient's safety is at risk due to possible hypoglycemia.

5. A nurse is assessing a client who has a sodium level of 122 mEq/L. Which of the following findings should the nurse expect?

• A. Decreased deep tendon reflexes
• B. Positive Chvostek's sign
• C. Hyperactive bowel sounds
• D. Dry mucous membranes

Correct answer: A

Rationale: Corrected deep tendon reflexes occur with hyponatremia. Other manifestations of hyponatremia include headache, confusion, lethargy, fatigue, seizures, and muscle weakness. Positive Chvostek's sign is associated with hypocalcemia, hyperactive bowel sounds are not typically related to hyponatremia, and dry mucous membranes are more commonly seen with dehydration.

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