Nursing Elites

1. A client with a history of chronic alcohol use is admitted with confusion and an unsteady gait. Which deficiency should the nurse suspect?

• A. Thiamine (Vitamin B1)
• B. Cyanocobalamin (Vitamin B12)
• C. Folic acid
• D. Vitamin D

Correct answer: A

Rationale: The correct answer is Thiamine (Vitamin B1). Chronic alcohol use can lead to thiamine deficiency, which can result in neurological symptoms such as confusion and an unsteady gait. Thiamine is essential for proper brain function and nerve conduction, and its deficiency is common in individuals with alcohol use disorder. Cyanocobalamin (Vitamin B12) deficiency can also present with neurological symptoms, but in this case, the patient's history of chronic alcohol use points more towards thiamine deficiency. Folic acid deficiency typically presents with symptoms like fatigue and megaloblastic anemia. Vitamin D deficiency is associated with bone health issues rather than neurological symptoms.

2. The client with newly diagnosed osteoporosis is being taught by the nurse about dietary modifications. Which instruction should the nurse include?

• A. Increase your intake of high-calcium foods.
• B. Limit your intake of vitamin D-rich foods.
• C. Avoid foods high in phosphorus.
• D. Increase your intake of high-sodium foods.

Correct answer: A

Rationale: Increasing the intake of high-calcium foods is essential for improving bone density and managing osteoporosis. Calcium is a key mineral necessary for bone health, and individuals with osteoporosis often need higher levels of calcium to help strengthen their bones and prevent further bone loss. Therefore, advising the client to increase their intake of high-calcium foods is the most appropriate dietary modification to support their bone health.

3. When planning care for a 16-year-old with appendicitis presenting with right lower quadrant pain, what should the nurse prioritize as a nursing diagnosis?

• A. Imbalanced nutrition: Less than body requirements related to decreased oral intake
• B. Risk for infection related to possible rupture of the appendix
• C. Constipation related to decreased bowel motility and decreased fluid intake
• D. Chronic pain related to appendicitis

Correct answer: B

Rationale: The priority nursing diagnosis for a client with appendicitis is the 'Risk for infection related to possible rupture of the appendix.' Appendicitis carries a risk of the appendix rupturing, which can lead to peritonitis, a life-threatening condition. Preventing infection through timely intervention and surgery is critical in the care of a client with appendicitis, making this nursing diagnosis the priority.

4. A patient with depression is prescribed fluoxetine. What is an important side effect for the nurse to monitor?

• A. Weight gain
• B. Bradycardia
• C. Dry mouth
• D. Suicidal thoughts

Correct answer: D

Rationale: When a patient with depression is prescribed fluoxetine, the nurse should be vigilant for the potential side effect of increased risk of suicidal thoughts. Fluoxetine, like other antidepressants, may elevate the risk of suicidal thoughts, particularly during the initial phases of treatment. Monitoring the patient for any indications of heightened depression or suicidal ideation is crucial to ensure appropriate interventions are implemented promptly.

5. A client with long-standing obesity has been prescribed phentermine/topiramate-ER. What statement by the client suggests that further health education is necessary?

• A. I'm so relieved to start this medication. I really don't like having to exercise or change what I eat.
• B. It's hard to believe that there are actually medications that can treat obesity.
• C. I'm a bit nervous to start this medication because I know I'll need blood tests sometimes.
• D. I'm going to have to do some rearranging of my finances to make sure I can afford this medication.

Correct answer: A

Rationale: Choice A suggests the need for further health education as the client expresses a reluctance to exercise or change dietary habits, indicating a lack of understanding about the importance of lifestyle modifications in conjunction with medication for effective weight management. It is important for the client to comprehend that a holistic approach, including lifestyle changes, is crucial for successful obesity treatment and long-term health benefits.

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