Nursing Elites

1. Cocaine is derived from the leaves of coca plant; the nurse knows that cocaine is classified as:

• A. Narcotic
• B. Stimulant
• C. Barbiturate
• D. Hallucinogen

Correct answer: A

Rationale: Patient safety and efficacy of care depend on actions rooted in established nursing protocols that consider both the immediate and long-term needs of the patient.

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. The RDA for iron is higher in premenopausal women than for men or postmenopausal women because of the blood loss during menstruation.

• A. Both the statement and the reason are correct and related.
• B. Both the statement and the reason are correct but are not related.
• C. The statement is correct, but the reason is not correct.
• D. The statement is not correct, but the reason is correct.

Correct answer: A

Rationale: Both the statement and the reason are correct and related. The Institute of Medicine (IOM) recommends 18 mg of iron per day for women 19 to 50 years old, 8 mg/day for women 51 years old and older, and men 19 years old and older. During menstruation, women lose blood containing iron, leading to a higher iron requirement in premenopausal women compared to men or postmenopausal women. This increased demand aims to replenish the iron lost during this physiological process. Therefore, the statement and reason are directly linked, explaining why the RDA for iron is higher in premenopausal women than in men or postmenopausal women. Choices B, C, and D are incorrect as they do not accurately assess the relationship between the statement and the reason provided in the question.

4. A nurse is completing an admission assessment on an adolescent client who is vegan. Which breakfast item should the nurse recommend as a protein combination with their diet restriction?

• A. Bagel with cream cheese
• B. Wheat toast with jelly
• C. Oatmeal pancakes with peanut butter
• D. Eggs with tofu bacon

Correct answer: C

Rationale: The correct answer is C: Oatmeal pancakes with peanut butter. For a vegan client, it is important to recommend plant-based protein sources. Oatmeal pancakes with peanut butter offer a good protein combination that aligns with their dietary restriction. Choices A, B, and D are not suitable as they all contain animal-derived products, which are not suitable for a vegan diet.

5. What is the most likely complication for a client receiving TPN who suddenly develops tremors, dizziness, and diaphoresis?

• A. Fluid volume overload
• B. Sepsis
• C. Hyperglycemia
• D. Hypoglycemia

Correct answer: D

Rationale: The correct answer is D, Hypoglycemia. When a client receiving TPN suddenly develops tremors, dizziness, and diaphoresis, it is indicative of hypoglycemia. TPN provides a high concentration of glucose, and if it is abruptly stopped or the infusion rate is reduced, it can lead to hypoglycemia. Choices A, B, and C are incorrect as they do not directly correlate with the symptoms described in the scenario. Fluid volume overload typically presents with edema and hypertension, sepsis with fever and increased heart rate, and hyperglycemia with polyuria, polydipsia, and blurred vision.

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