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1. A client with Crohn's disease is receiving parenteral nutrition. Which of the following interventions should the nurse not include in the care of this client?
- A. Remove the parenteral nutrition solution from the refrigerator 2 hours before infusion.
- B. Remove unused parenteral nutrition after 12 hours of use.
- C. Monitor daily laboratory values and report abnormalities as needed.
- D. Monitor the flow rate of the parenteral nutrition carefully and adjust it if necessary.
Correct answer: B
Rationale: In caring for a client receiving parenteral nutrition, it is important to follow proper guidelines to ensure safety and effectiveness. Unused parenteral nutrition should be removed after 24 hours, not 12 hours, to prevent contamination and reduce the risk of infection. Option A is correct as it ensures the solution is at room temperature before infusion. Option C is essential for monitoring the client's response to parenteral nutrition. Option D is important to maintain the correct flow rate and adjust it as needed. Therefore, option B is the incorrect choice among the options provided.
2. Which of the following is not a desirable blood lipid value?
- A. low total cholesterol
- B. high LDL
- C. high HDL
- D. low blood triglycerides
Correct answer: B
Rationale: The correct answer is B. High levels of LDL (low-density lipoprotein) cholesterol are undesirable as they are associated with an increased risk of cardiovascular disease. Therefore, low total cholesterol (choice A), high HDL (choice C), and low blood triglycerides (choice D) are considered desirable blood lipid values. Low total cholesterol is beneficial as high levels can increase the risk of heart disease. High HDL cholesterol is considered good as it helps remove LDL cholesterol from the arteries. Low blood triglycerides are also preferred as high levels are associated with an increased risk of heart disease.
3. The nurse is caring for a client taking warfarin. Which meal brought in by the client's family is a priority to remove before the client eats it?
- A. Oriental cabbage salad with chicken
- B. Beef enchilada, rice, and beans
- C. Ham and cheese sandwich
- D. Macaroni salad and grapefruit slices
Correct answer: C
Rationale: The correct answer is C. Ham is high in vitamin K, which can interfere with warfarin. Vitamin K can decrease the effectiveness of warfarin, an anticoagulant medication. Choices A, B, and D do not contain high levels of vitamin K and are less likely to interfere with the client's warfarin therapy.
4. A fire has broken in the unit of DMLM R.N. The best leadership style suited in cases of emergencies like this is:
- A. Autocratic
- B. Participative
- C. Democratic
- D. Laissez Faire
Correct answer: D
Rationale: Understanding the underlying pathology and therapeutic techniques ensures that nursing care is not only reactive but also preventative, reducing the risk of complications.
5. What is the first thing you should do before sharing information with a patient?
- A. Provide background knowledge
- B. Ask for permission
- C. Remove personal protective equipment (PPE)
- D. Remind the patient that you are the authority
Correct answer: B
Rationale: Before sharing information with a patient, it is essential to ask for their permission. This action respects the patient's autonomy and encourages their participation in the learning process. Asking for permission establishes a foundation of trust and partnership between the healthcare provider and the patient. Providing background knowledge (Choice A) is important, but it should come after receiving consent to share information. Removing personal protective equipment (Choice C) is not related to the communication process. Reminding the patient that you are the authority (Choice D) is inappropriate as it can undermine the patient's autonomy and hinder effective communication in a patient-centered care approach.
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