Nursing Elites

1. A healthcare professional is reviewing laboratory results for a client who has cirrhosis. Which of the following findings should the professional report to the provider?

• A. Albumin 3.5 g/dL
• B. Bilirubin 1.0 mg/dL
• C. INR 3.0
• D. Ammonia 80 mcg/dL

Correct answer: C

Rationale: An INR of 3.0 is elevated, indicating impaired blood clotting function, which poses a significant risk of bleeding in clients with cirrhosis. This finding should be promptly reported to the provider for further evaluation and management. Choice A (Albumin 3.5 g/dL) is within the normal range and indicates adequate liver synthetic function, so it does not require immediate reporting. Choice B (Bilirubin 1.0 mg/dL) is also within the normal range and typically seen in clients without significant liver dysfunction, so it does not need urgent attention. Choice D (Ammonia 80 mcg/dL) is elevated, but it is not the priority finding in cirrhosis; elevated ammonia levels are associated with hepatic encephalopathy rather than increased bleeding risk.

2. A nurse is providing dietary teaching to a client with irritable bowel syndrome (IBS). Which of the following recommendations should the nurse include?

• A. Consume foods high in bran fiber.
• B. Increase intake of milk products.
• C. Sweeten foods with fructose corn syrup.
• D. Increase intake of foods high in gluten.

Correct answer: A

Rationale: The correct recommendation for a client with irritable bowel syndrome (IBS) is to consume foods high in bran fiber. Bran fiber promotes regularity and helps reduce IBS symptoms by aiding digestion and preventing constipation. Choices B, C, and D are incorrect. Increasing intake of milk products may exacerbate IBS symptoms in some individuals due to lactose intolerance. Sweetening foods with fructose corn syrup can worsen IBS symptoms as it may cause bloating and gas. Increasing intake of foods high in gluten may also be problematic for individuals with IBS as gluten-containing foods can trigger symptoms like abdominal pain and diarrhea.

3. A client has a new prescription for ferrous sulfate. Which of the following instructions should the nurse include in the teaching?

• A. Take this medication on an empty stomach.
• B. Take this medication with milk if it causes stomach upset.
• C. Take this medication with orange juice to increase absorption.
• D. Take an antacid 1 hour after this medication.

Correct answer: C

Rationale: The correct instruction is to take ferrous sulfate with orange juice to increase absorption because the vitamin C content in orange juice enhances iron absorption. Choice A is incorrect because ferrous sulfate should be taken with food to reduce gastrointestinal side effects. Choice B is incorrect because milk can decrease iron absorption. Choice D is incorrect because antacids can reduce the absorption of ferrous sulfate.

4. How should a healthcare provider manage a patient with a history of hypertension who is non-compliant with medication?

• A. Educate the patient on the importance of medication
• B. Reassess the patient in 6 months
• C. Refer the patient to a specialist
• D. Discontinue the medication

Correct answer: A

Rationale: Educating the patient on the importance of medication is crucial when dealing with a patient who is non-compliant with their hypertension medication. By providing information about the significance of the medication in controlling blood pressure and preventing complications, the patient may be more motivated to adhere to the prescribed treatment. Reassessing the patient in 6 months (choice B) may lead to further deterioration of the patient's condition if non-compliance continues. Referring the patient to a specialist (choice C) may be necessary in some cases but should be preceded by efforts to improve compliance. Discontinuing the medication (choice D) without addressing the non-compliance issue can have serious health consequences for the patient.

5. A nurse is teaching a client who has iron deficiency anemia about food choices to increase iron intake. Which of the following foods should the nurse recommend?

• A. Eggs
• B. Carrots
• C. White bread
• D. Spinach

Correct answer: D

Rationale: Spinach is an excellent choice to recommend as it is rich in non-heme iron, which can help improve iron levels in clients with iron deficiency anemia. Eggs (Choice A) are a good source of protein but do not contain as much iron as spinach. Carrots (Choice B) are rich in vitamin A but are not a significant source of iron. White bread (Choice C) is not a good source of iron compared to spinach.

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