Nursing Elites

1. Which action will be included in the care for a patient who has recently been diagnosed with asymptomatic nonalcoholic fatty liver disease (NAFLD)?

• A. Teach about symptoms of variceal bleeding
• B. Draw blood for hepatitis serology testing
• C. Discuss the need to increase caloric intake
• D. Review the patient's current medication list

Correct answer: D

Rationale: The correct action for a patient diagnosed with asymptomatic nonalcoholic fatty liver disease (NAFLD) would be to review the patient's current medication list. This is important because certain medications can increase the risk for NAFLD, and they should be identified and possibly eliminated. Teaching about symptoms of variceal bleeding is not necessary as variceal bleeding is not a concern in a patient with asymptomatic NAFLD. Drawing blood for hepatitis serology testing is not indicated as NAFLD is not associated with hepatitis. Discussing the need to increase caloric intake is also not appropriate since weight loss is usually recommended in the management of NAFLD.

2. The nurse is performing a neurological assessment on a client post right cerebrovascular accident. Which finding, if observed by the nurse, would warrant immediate attention?

• A. Decrease in level of consciousness
• B. Loss of bladder control
• C. Altered sensation to stimuli
• D. Emotional lability

Correct answer: A

Rationale: A decrease in the level of consciousness is a critical finding that would warrant immediate attention in a client post right cerebrovascular accident. This change may indicate an increase in intracranial pressure, leading to inadequate oxygenation of the brain. It could also reveal the presence of a transient ischemic attack, which may signal an impending thrombotic cerebrovascular accident. Loss of bladder control (choice B) can be managed and monitored but does not indicate an immediate threat to the client's life. Altered sensation to stimuli (choice C) can be a concerning finding but may not require immediate attention unless it affects the client's safety. Emotional lability (choice D) may be distressing for the client but does not pose an immediate risk to their health compared to a decrease in the level of consciousness.

3. Why should a 30-year-old Caucasian woman who works the night shift take Vitamin D supplements?

• A. It's a standard part of the overall nutritional treatment for the prevention of osteomalacia.
• B. It helps your intestines absorb calcium, which is important for bone formation.
• C. It stimulates skin cells to produce calcium, which is then released into the bloodstream to be used for bone formation.
• D. Vitamin D supplements should not be taken by someone of your age.

Correct answer: B

Rationale: The correct answer is B: 'It helps your intestines absorb calcium, which is important for bone formation.' Vitamin D plays a crucial role in aiding the absorption of calcium from the intestines into the bloodstream, which is essential for bone health and formation. Choice A is incorrect because it does not specifically address the role of Vitamin D in calcium absorption. Choice C is incorrect as Vitamin D does not stimulate skin cells to produce calcium; rather, it helps regulate calcium levels in the body. Choice D is incorrect as age alone is not a contraindication for Vitamin D supplementation; the need for supplementation is based on individual health status and risk factors.

4. A client complained of nausea, a metallic taste in her mouth, and fine hand tremors 2 hours after her first dose of lithium carbonate (Lithane). What is the nurse's best explanation of these findings?

• A. These side effects are common and should subside in a few days.
• B. The client is probably having an allergic reaction and should discontinue the drug.
• C. Taking the lithium on an empty stomach should decrease these symptoms.
• D. Decreasing dietary intake of sodium and fluids should minimize the side effects.

Correct answer: A

Rationale: The correct answer is, 'These side effects are common and should subside in a few days.' Nausea, metallic taste, and fine hand tremors are common side effects of lithium carbonate (Lithane) and typically diminish within a few days as the body adjusts to the medication. Option B is incorrect because these symptoms are not indicative of an allergic reaction. Option C is incorrect as taking lithium on an empty stomach does not directly address or decrease these specific side effects. Option D is also incorrect as reducing sodium and fluid intake is not the recommended approach to managing these particular side effects of lithium.

5. A victim of domestic violence states, 'If I were better, I would not have been beaten.' Which feeling best describes what the victim may be experiencing?

• A. Fear
• B. Helplessness
• C. Self-blame
• D. Rejection

Correct answer: C

Rationale: The correct answer is self-blame. In this scenario, the victim is attributing the abuse to their own inadequacies or faults, thinking that if they were different, the abuse would not occur. This is a common response seen in victims of domestic violence, where they wrongly internalize the blame for the abuser's actions. Fear (Choice A) is a valid emotion, but in this case, the victim is not expressing fear but rather self-blame. Helplessness (Choice B) is also a common feeling in victims of domestic violence, but in this specific statement, the victim is demonstrating self-blame. Rejection (Choice D) does not accurately reflect the victim's statement and emotional response in the given scenario.

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