Nursing Elites

1. Which of the following foods present a problem for a client diagnosed with Celiac Disease?

• A. butter
• B. oats or barley cereal
• C. fresh vegetables
• D. coffee or tea

Correct answer: B

Rationale: Celiac disease, also known as celiac sprue, is a malabsorption disorder affecting the small intestine due to a problem with ingesting gluten, a protein found in wheat, rye, oats, and barley. Therefore, oats or barley cereal would present a problem for a client with Celiac Disease as they contain gluten. Fresh vegetables, butter, coffee, and tea, on the other hand, do not contain gluten and should not pose any issues for individuals with this disorder. Therefore, the correct answer is oats or barley cereal. Choices A, C, and D are not problematic for clients with Celiac Disease as they are gluten-free.

2. An LPN is having a conflict with another nurse during her shift. She has tried to discuss the issues with the nurse with no resolution. What is the most appropriate way for the LPN to proceed?

• A. Report the conflict to the director of nursing over the unit.
• B. Report the conflict to the assigned charge nurse of the unit.
• C. Report the conflict to the nurse manager of the unit.
• D. Discuss the conflict with the other nurse to attempt resolution of the issue.

Correct answer: B

Rationale: In this scenario, the most appropriate way for the LPN to proceed is to report the conflict to the assigned charge nurse of the unit. Following the chain of command is crucial in a professional setting to address conflicts effectively. Reporting the issue to the charge nurse, who is the immediate supervisor, allows for a structured approach to resolving the conflict. Reporting directly to higher levels such as the director of nursing or nurse manager may bypass the appropriate hierarchy and could create unnecessary tension. Attempting to resolve the issue independently with the other nurse may not be effective if previous attempts have failed, making it essential to involve the immediate supervisor.

3. Which of the following foods might a client with hypercholesterolemia need to decrease intake of?

• A. broiled catfish
• B. hamburgers
• C. wheat bread
• D. fresh apples

Correct answer: B

Rationale: A client with hypercholesterolemia needs to decrease intake of foods that are high in cholesterol. Red meats like hamburgers are high in cholesterol, so their consumption should be reduced. Broiled catfish, wheat bread, and fresh apples are not high in cholesterol and do not need to be decreased in the client's diet. Therefore, the correct answer is hamburgers, as they are more likely to contribute to elevated cholesterol levels compared to the other options provided.

4. The client asks the nurse not to tell anyone outside of the care team about his positive HIV diagnosis. What response is most appropriate?

• A. "I have to inform all clients on the unit of your diagnosis as it is transmissible."?
• B. "I will not communicate your diagnosis to anyone without your permission."?
• C. "Because this is a communicable disease, it may need to be reported to the CDC."?
• D. "You should not be concerned with who I share your diagnosis with."?

Correct answer: C

Rationale: The most appropriate response is C: "Because this is a communicable disease, it may need to be reported to the CDC."? It is important to uphold patient confidentiality, but in the case of certain communicable diseases like HIV, there are legal requirements for mandatory reporting to public health authorities such as the CDC. Option A is incorrect because it violates patient confidentiality and does not consider legal obligations. Option B, while respecting the client's wishes, may not align with the legal requirement for reporting certain communicable diseases. Option D is inappropriate as it dismisses the client's concerns and rights regarding their health information.

5. A nurse is planning the assignments for the shift. Which task should the nurse assign to the nursing assistant?

• A. Monitoring the vital signs for a client who needs a blood transfusion
• B. Performing hygiene for a client with diarrhea on whom contact precautions have been imposed
• C. Performing a dressing change on a client with a draining abdominal wound that requires frequent dressing changes
• D. Ambulating a client with angina who needs to be ambulated for the first time since admission

Correct answer: B

Rationale: When assigning tasks, a nurse should consider the job description of the nursing assistant, their clinical competence, and state law. Monitoring vital signs for a client needing a blood transfusion, performing a dressing change on a client with a draining wound, and ambulating a client with angina are tasks that require a licensed nurse's skill. On the other hand, providing hygiene care for a client with diarrhea under contact precautions is a task suitable for a nursing assistant. Nursing assistants are trained to provide hygiene care effectively and manage clients under specific precautions, making this task appropriate for them.

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