Nursing Elites

1. A 14-year-old with a history of sickle cell disease is admitted to the hospital with a diagnosis of vaso-occlusive crisis. Which statement by the client would be most indicative of the etiology of this crisis?

• A. I knew this would happen. I've been eating too much red meat lately.
• B. I really enjoyed my fishing trip yesterday. I caught 2 fish.
• C. I have really been working hard practicing with the debate team at school.
• D. I went to the healthcare provider last week for a cold, and I have gotten worse.

Correct answer: D

Rationale: The correct answer is D because a recent illness, such as a cold, can trigger a vaso-occlusive crisis in sickle cell disease. This crisis is often precipitated by infections or other illnesses that cause a systemic inflammatory response, leading to vaso-occlusion. Choices A, B, and C do not directly relate to the etiology of a vaso-occlusive crisis in sickle cell disease, making them incorrect.

2. The client with infective endocarditis must be assessed frequently by the home health nurse. Which finding suggests that antibiotic therapy is not effective and must be reported by the nurse immediately to the healthcare provider?

• A. Nausea and vomiting
• B. Fever of 103 degrees Fahrenheit (39.5 degrees Celsius)
• C. Diffuse macular rash
• D. Muscle tenderness

Correct answer: B

Rationale: A high fever, such as 103 degrees Fahrenheit (39.5 degrees Celsius), in a client with infective endocarditis indicates that the infection may not be responding to the antibiotics and requires immediate medical evaluation. Nausea and vomiting, diffuse macular rash, and muscle tenderness are not typically associated with the ineffectiveness of antibiotic therapy in infective endocarditis.

3. A client who is 2 days postoperative following abdominal surgery is transitioning from a clear liquid diet to a full liquid diet. The nurse should remind the client that which of the following items is included in a full liquid diet?

• A. Creamed peas
• B. Cottage cheese
• C. Chocolate pudding
• D. Applesauce

Correct answer: C

Rationale: The correct answer is C, chocolate pudding. A full liquid diet consists of smooth, creamy foods like pudding. Creamed peas (choice A) are not typically allowed on a full liquid diet as they may contain solid pieces. Cottage cheese (choice B) and applesauce (choice D) are also not part of a full liquid diet as they are not in liquid form.

4. A healthcare professional is assisting with the development of an education program about nutritional risk among adolescents to a group of parents of adolescents. Which of the following information should the healthcare professional include in the teaching? (Select all that apply).

• A. Skipping more than three meals per week
• B. Eating fast food once a week
• C. Hearty appetite
• D. Drink whole milk to ensure adequate calcium intake.

Correct answer: A

Rationale: Skipping more than three meals per week is an indicator of poor nutritional habits in adolescents. This can lead to inadequate nutrient intake and negatively impact growth and development. Choices B, C, and D are not directly associated with poor nutritional habits among adolescents. Eating fast food once a week may not necessarily indicate poor nutrition if the overall diet is balanced. Having a hearty appetite does not provide specific information about nutritional risk, as appetite can vary among individuals. While whole milk can be a source of calcium, it is not necessary to drink whole milk specifically to ensure adequate calcium intake, as there are other sources of calcium available.

5. What should a client with diarrhea avoid consuming?

• A. Orange juice
• B. Tuna
• C. Eggs
• D. Macaroni

Correct answer: A

Rationale: A client with diarrhea should avoid consuming orange juice. Orange juice is high in sugar content, which can worsen diarrhea symptoms by drawing water into the intestines, potentially leading to further dehydration and discomfort. Tuna, eggs, and macaroni are generally well-tolerated and do not exacerbate diarrhea symptoms, making them more suitable food choices for individuals experiencing diarrhea.

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