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. A nurse is caring for a client who has bipolar disorder and is experiencing acute mania. The nurse obtained a verbal prescription for restraints. Which of the following actions should the nurse take?

• A. Request a renewal of the prescription every 8 hours.
• B. Check the client's peripheral pulse rate every 30 minutes.
• C. Obtain a prescription for restraint within 4 hours.
• D. Document the client's condition every 15 minutes.

Correct answer: D

Rationale: In a situation where a verbal prescription for restraints is obtained for a client experiencing acute mania, the nurse should document the client's condition every 15 minutes. This frequent documentation allows for accurate monitoring of the client's condition, ensuring safety and compliance. Requesting a renewal of the prescription every 8 hours (Choice A) is not necessary as the focus should be on monitoring the client's condition. Checking the client's peripheral pulse rate every 30 minutes (Choice B) is not directly related to the need for restraints in this scenario. Obtaining a prescription for restraint within 4 hours (Choice C) is not a priority when a verbal prescription is already obtained and immediate action is needed for the client's safety.

3. A healthcare provider is reviewing the medical record of a client who has hypertension. Which of the following findings should the provider identify as a risk factor for this condition?

• A. Age 25 years
• B. Family history of hypotension
• C. Obesity
• D. History of hypotension

Correct answer: C

Rationale: The correct answer is C: Obesity. Obesity is a significant risk factor for hypertension due to its impact on the cardiovascular system. Obesity can lead to increased blood pressure due to the additional workload placed on the heart and blood vessels. Age alone does not necessarily predispose someone to hypertension, and a family history of hypotension or a personal history of hypotension would not increase the risk of developing hypertension. Family history of hypotension is not a known risk factor for hypertension, and a history of hypotension actually indicates low blood pressure, which is the opposite of hypertension.

4. A nurse is caring for a client who is postoperative following a thyroidectomy and reports tingling and numbness in the hands. The nurse should expect to administer which of the following medications?

• A. Sodium bicarbonate.
• B. Calcium gluconate.
• C. Potassium chloride.
• D. Magnesium sulfate.

Correct answer: B

Rationale: Tingling and numbness in the hands can indicate hypocalcemia, a common complication following a thyroidectomy. Hypocalcemia requires immediate intervention to prevent severe complications like tetany and seizures. Calcium gluconate is the drug of choice for rapidly raising serum calcium levels in hypocalcemic patients. Sodium bicarbonate is not indicated for treating hypocalcemia or related symptoms. Potassium chloride is used to correct potassium imbalances, not calcium. Magnesium sulfate is not the appropriate treatment for hypocalcemia; it is commonly used for conditions like preeclampsia or eclampsia.

5. A client with acute diverticulitis is receiving teaching from a nurse. Which of the following statements by the client indicates an understanding of the instructions?

• A. I will avoid eating fiber until this condition resolves
• B. I will take a laxative daily
• C. I will receive the nutrients I need through my IV fluids
• D. I will eat only solid foods

Correct answer: A

Rationale: The correct answer is A. During acute diverticulitis, avoiding fiber is essential as it helps reduce irritation of the intestines. Choice B is incorrect because taking a laxative daily can exacerbate diverticulitis. Choice C is incorrect as IV fluids mainly provide hydration and electrolytes, not all essential nutrients. Choice D is incorrect because during acute diverticulitis, a low-fiber or liquid diet is typically recommended to rest the bowel.

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