Nursing Elites

1. Why may patients with hiatal hernia develop anemia?

• A. Iron absorption is reduced
• B. Gastritis may cause bleeding
• C. Iron stores turn over more quickly
• D. Patients have an aversion to foods that are good sources of iron

Correct answer: B

Rationale: The correct answer is B: Gastritis may cause bleeding. In patients with hiatal hernia, gastritis can lead to gastrointestinal bleeding, resulting in anemia due to blood loss. Choice A is incorrect because hiatal hernia does not directly affect iron absorption. Choice C is incorrect as iron stores turning over more quickly is not a typical reason for anemia in hiatal hernia patients. Choice D is incorrect as an aversion to iron-rich foods does not directly cause anemia in this context.

2. The nurse counsels a client diagnosed with iron deficiency anemia. The nurse determines that teaching is effective if the client selects which of the following menus?

• A. Roast beef, brown rice, green beans, carrot and raisin salad, and milk
• B. Cheese pizza, tossed green salad, oatmeal-raisin cookie, and lemonade
• C. Two scrambled eggs, bacon, white toast with strawberry jam, and coffee
• D. Corn flakes with milk, whole wheat toast, and orange juice

Correct answer: A

Rationale: The correct answer is A. Roast beef is high in heme iron, which is best absorbed and helps treat iron deficiency anemia. Choices B, C, and D do not contain significant sources of iron, especially heme iron, making them less effective in treating iron deficiency anemia.

3. A family came to the emergency department with complaints of food poisoning. Which client should the nurse see first?

• A. 32-year-old with diarrhea for 6 hours
• B. 2-year-old with 1 wet diaper in 24 hours
• C. 40-year-old with abdominal cramping
• D. 10-year-old who is nauseated

Correct answer: B

Rationale: In cases of food poisoning, a 2-year-old with reduced urine output is a critical finding indicating dehydration, requiring immediate attention to prevent complications. The reduced urine output is a sign of decreased fluid intake or increased fluid loss, putting the child at high risk for dehydration. This client should be seen first to assess hydration status, initiate necessary interventions, and prevent further complications. While the other symptoms presented by the other clients are concerning, the 2-year-old's decreased urine output poses the most immediate threat to their well-being.

4. Protecting the rights and privacy of the patient and their family is a part of which of the following steps for determining and fulfilling the nursing care needs of the patient?

• A. Evaluation
• B. Planning
• C. Implementation
• D. Assessment

Correct answer: C

Rationale: In nursing care, implementation involves putting the nursing care plan into action. This step includes safeguarding the rights and privacy of the patient and their family by providing care in a respectful and confidential manner. Evaluation (A) is about assessing the effectiveness of the care provided. Planning (B) is the stage where specific interventions are designed. Assessment (D) is the initial step where data is collected to identify the patient's needs.

5. Which instructions should the nurse discuss with the client diagnosed with Raynaud’s phenomenon?

• A. Explain that exacerbations will not occur in the summer
• B. Use nicotine gum to help quit smoking
• C. Wear extra warm clothing during cold exposure
• D. Avoid prolonged exposure to direct sunlight

Correct answer: C

Rationale: The correct instruction for a client diagnosed with Raynaud’s phenomenon is to wear extra warm clothing during cold exposure. This is essential in preventing vasospasms triggered by cold temperatures, which can worsen symptoms of Raynaud's phenomenon. Choice A is incorrect because exacerbations can occur in any season. Choice B is irrelevant and not directly related to managing Raynaud's phenomenon. Choice D is also incorrect as sunlight exposure does not significantly impact Raynaud's phenomenon.

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