Nursing Elites

1. A 48-year-old client with chronic alcoholism is admitted to the hospital. The nurse would anticipate that the client may be deficient in which vitamins?

• A. Vitamin B and vitamin C
• B. Vitamin D and vitamin E
• C. Vitamin K and vitamin A
• D. Vitamin A and vitamin E

Correct answer: A

Rationale: The correct answer is A. Chronic alcoholism commonly leads to deficiencies in B vitamins, particularly thiamine, and vitamin C. Thiamine deficiency can result in serious neurological issues like Wernicke-Korsakoff syndrome, while vitamin C deficiency can lead to scurvy. Choices B, C, and D are incorrect because vitamin D and E deficiencies are not typically associated with chronic alcoholism.

2. The nurse prepares a discharge plan for an older adult client following cataract extraction. What instructions should the nurse provide?

• A. Avoid straining, bending, or lifting heavy objects.
• B. Limit exposure to sunlight for the first 2 weeks.
• C. Irrigate the conjunctiva with saline before applying ointment.
• D. Read without direct lighting for 6 weeks.

Correct answer: A

Rationale: The correct instruction for the nurse to provide after cataract extraction is to advise the client to avoid straining, bending, or lifting heavy objects. These activities can increase intraocular pressure, which should be minimized post-surgery to promote healing and prevent complications. Choices B, C, and D are incorrect because limiting sunlight exposure, irrigating the conjunctiva with saline, and reading without direct lighting are not primary instructions following cataract extraction.

3. A client with cirrhosis is experiencing ascites and peripheral edema. What is the nurse's priority intervention?

• A. Administer furosemide as prescribed.
• B. Administer albumin to increase oncotic pressure.
• C. Elevate the client's legs to reduce swelling.
• D. Administer a sodium-restricted diet.

Correct answer: A

Rationale: The correct answer is A: Administer furosemide as prescribed. Administering furosemide, a loop diuretic, is the priority intervention in a client with cirrhosis experiencing ascites and peripheral edema. Furosemide helps promote diuresis and reduce fluid buildup in the body. Choice B, administering albumin to increase oncotic pressure, may be beneficial in some cases but is not the priority intervention for immediate fluid removal. Elevating the client's legs (Choice C) and administering a sodium-restricted diet (Choice D) are important aspects of managing edema and ascites but are not the priority interventions in this situation.

4. Which meal option should the nurse recommend for a client with renal disease who is following a low-protein diet?

• A. Grilled chicken with steamed vegetables
• B. Tofu stir-fry with rice
• C. Pasta with marinara sauce
• D. Baked salmon with quinoa

Correct answer: C

Rationale: The correct answer is C: Pasta with marinara sauce. Clients with renal disease following a low-protein diet should opt for lower-protein options. Pasta with marinara sauce is a suitable choice as it is lower in protein compared to grilled chicken, tofu, or salmon. Grilled chicken, tofu, and salmon are higher in protein content and are not ideal for individuals following a low-protein diet for renal disease as they may strain the kidneys.

5. A nurse is reviewing the medication list for a client with heart failure. Which medication should the nurse question?

• A. Furosemide
• B. Digoxin
• C. Ibuprofen
• D. Carvedilol

Correct answer: C

Rationale: The correct answer is C: Ibuprofen. Ibuprofen, a nonsteroidal anti-inflammatory drug (NSAID), can cause fluid retention, which may worsen heart failure symptoms. It should be used with caution or avoided in clients with heart failure. Furosemide (choice A) is a diuretic commonly used in heart failure to reduce fluid overload. Digoxin (choice B) is a medication that helps the heart beat stronger and slower, often used in heart failure. Carvedilol (choice D) is a beta-blocker that is beneficial in heart failure management. Therefore, Ibuprofen is the medication that the nurse should question in this scenario.

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