Nursing Elites

1. Which dietary instruction is appropriate for a client with chronic kidney disease?

• A. Increase the intake of potassium
• B. Limit the intake of phosphorus-rich foods
• C. Encourage the intake of protein-rich foods
• D. Advise the client to increase fluid intake

Correct answer: B

Rationale: Limiting the intake of phosphorus-rich foods is appropriate for a client with chronic kidney disease. In individuals with chronic kidney disease, the kidneys cannot filter phosphorus effectively, leading to a buildup in the blood. This can result in bone and heart problems. Therefore, reducing phosphorus intake is crucial to prevent complications. Choices A, C, and D are incorrect. Increasing potassium intake may be harmful as potassium levels can accumulate in the blood with impaired kidney function. Encouraging protein-rich foods may not be suitable as excessive protein intake can strain the kidneys. Advising to increase fluid intake should be done cautiously as individuals with chronic kidney disease may need to restrict fluids based on their stage of the disease.

2. What is the nurse's priority when caring for a client with a tracheostomy who is showing signs of respiratory distress?

• A. Administer a bronchodilator
• B. Suction the tracheostomy
• C. Notify the physician immediately
• D. Increase the oxygen flow rate

Correct answer: B

Rationale: The correct answer is to suction the tracheostomy. When a client with a tracheostomy is experiencing respiratory distress, the priority intervention is to clear the airway by suctioning the tracheostomy to remove secretions that may be obstructing the air passage. Administering a bronchodilator (Choice A) may be considered if bronchospasm is present, but the immediate focus should be on clearing the airway. Notifying the physician (Choice C) is important but should not delay the immediate intervention of suctioning. Increasing the oxygen flow rate (Choice D) may provide temporary relief, but addressing the root cause of the distress by suctioning is the priority.

3. What are the primary differences between Type 1 and Type 2 diabetes in terms of pathophysiology and treatment?

• A. Type 1: No insulin production; Type 2: Insulin resistance
• B. Type 1: Insulin resistance; Type 2: Insulin deficiency
• C. Type 1: Autoimmune; Type 2: Lifestyle-related
• D. Type 1: Insulin therapy; Type 2: Diet modification

Correct answer: A

Rationale: The correct answer is A. Type 1 diabetes is characterized by the absence of insulin production, while Type 2 diabetes involves insulin resistance. Choice B is incorrect because Type 1 diabetes is not related to insulin resistance. Choice C is inaccurate as Type 1 diabetes is autoimmune while Type 2 diabetes is more associated with lifestyle factors. Choice D is not correct since insulin therapy is primarily used in Type 1 diabetes, whereas diet modification is a common approach in managing Type 2 diabetes.

4. A nurse is reviewing the plan of care for a client who is undergoing total parenteral nutrition (TPN). Which of the following interventions should the nurse include?

• A. Monitor the client's electrolyte levels daily
• B. Weigh the client daily
• C. Monitor the client's blood glucose levels every 6 hours
• D. Change the TPN tubing every 24 hours

Correct answer: D

Rationale: The correct intervention for the nurse to include in the plan of care for a client undergoing total parenteral nutrition (TPN) is to change the TPN tubing every 24 hours. Changing the tubing at regular intervals helps reduce the risk of infection associated with central venous catheters. Monitoring electrolyte levels daily (Choice A) is important but not specific to TPN. Weighing the client daily (Choice B) is important for monitoring fluid status but not directly related to TPN. Monitoring blood glucose levels every 6 hours (Choice C) is essential for clients receiving TPN, but changing the tubing is a more critical intervention to prevent infections.

5. What is the best approach to assist a client in performing self-care after an acute myocardial infarction, when the client expresses concern about fatigue?

• A. Provide clear instructions on how to ask for assistance
• B. Gradually resume self-care tasks, focusing on rest periods
• C. Encourage assistive personnel to complete self-care tasks
• D. Encourage the client to remain in bed until fully rested

Correct answer: B

Rationale: The best approach to assist a client in performing self-care after an acute myocardial infarction, especially when the client expresses concern about fatigue, is to gradually resume self-care tasks while focusing on rest periods. This approach allows the client to build confidence in managing their self-care activities while also addressing the issue of fatigue. Choice A is incorrect as it focuses on asking for assistance rather than promoting self-care. Choice C is inappropriate as it suggests delegating the client's self-care tasks to assistive personnel instead of empowering the client. Choice D is incorrect as it can lead to deconditioning and is not conducive to the client's recovery process.

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