Nursing Elites

1. A nurse is preparing a teaching plan for a client who has neutropenia as a result of radiation therapy for the treatment of lung cancer. Which of the following should the nurse plan to include in the teaching?

• A. Bottled water is an appropriate choice to increase fluid intake.
• B. The salad bar is a healthy choice when dining out.
• C. Soft-boiled eggs are an appropriate source of protein.
• D. Eating at a buffet is a good choice to increase caloric intake.

Correct answer: A

Rationale: In neutropenia, which is a low count of neutrophils, the client is at a high risk of infection. It is crucial to emphasize the importance of proper hydration to maintain overall health. Bottled water is a safe choice as it reduces the risk of exposure to contaminants that could further compromise the client's immune system. The other options, like the salad bar, soft-boiled eggs, and eating at a buffet, may not be suitable for a client with neutropenia due to the risk of bacterial contamination or exposure to pathogens that could lead to infections, which should be avoided.

2. The nurse is completing a nutritional assessment on a client. Which statement made by the client is most concerning to the nurse?

• A. "I notice when I take a vitamin E supplement, I bruise more easily."
• B. "I work nights and rarely go outside during the day."
• C. "I take warfarin, so I need to limit the amount of green leafy vegetables I eat."
• D. "My vitamin supplement has the recommended daily allowance of vitamin A."

Correct answer: A

Rationale: The correct answer is A. Excessive intake of vitamin E can increase the risk of bleeding as it acts as a blood thinner. Bruising easily may indicate too much vitamin E. Choice B is not as concerning as it describes a lifestyle that may lead to vitamin D deficiency due to lack of sunlight exposure. Choice C shows awareness of the interaction between warfarin and vitamin K, which is expected. Choice D indicates knowledge of the vitamin A content in the supplement, which is not a cause for concern.

3. Amy is a 68-year-old patient who has rheumatoid arthritis affecting her hands and feet. Which substance has been shown to reduce joint tenderness and improve mobility in some people with this type of arthritis?

• A. Alfalfa Tea
• B. Cod Liver Oil
• C. Lecithin
• D. Fish Oil

Correct answer: D

Rationale: Fish oil has been identified as a substance that can help reduce joint tenderness and improve mobility in individuals with rheumatoid arthritis, as it is rich in omega-3 fatty acids. Omega-3 fatty acids have anti-inflammatory properties that can help alleviate the symptoms of rheumatoid arthritis. On the other hand, while Alfalfa Tea, Cod Liver Oil, and Lecithin have various health benefits, there isn't substantial evidence to suggest that they can improve conditions associated with rheumatoid arthritis.

4. A nurse is reinforcing dietary teaching with a client who has vitamin A deficiency. Which of the following food choices should the nurse recommend as the best source of vitamin A?

• A. 1 small baked sweet potato
• B. 1 cup avocado
• C. 1 cup green beans
• D. 1 large apple

Correct answer: A

Rationale: The correct answer is A. Sweet potatoes are rich in beta-carotene, which the body converts into vitamin A, essential for vision and immune function. Avocado (choice B) is a good source of healthy fats but not high in vitamin A. Green beans (choice C) are nutritious but not a significant source of vitamin A. Apples (choice D) are low in vitamin A compared to sweet potatoes.

5. Increasing the variety of foods often prevents nutrient excesses and toxicities. A dietary change to eliminate or increase intake of one specific food or nutrient usually alters the intake of other nutrients.

• A. Both statements are true.
• B. Both statements are false.
• C. The first statement is true; the second is false.
• D. The first statement is false; the second is true.

Correct answer: D

Rationale: The first statement is false because increasing the variety of foods actually helps prevent nutrient excesses and toxicities. The second statement is true because making a dietary change to eliminate or increase the intake of a specific food or nutrient often leads to alterations in the intake of other nutrients. Choice A is incorrect because the first statement is false. Choice B is incorrect because the second statement is true. Choice C is incorrect because the first statement is false, even though the second statement is true.

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