Nursing Elites

1. People at higher risk for drug-nutrient interactions include:

• A. Infants
• B. People with diabetes
• C. Women of childbearing age
• D. Older men and women

Correct answer: D

Rationale: Older men and women are at a higher risk for drug-nutrient interactions due to factors like polypharmacy, changes in metabolism, and physiological changes associated with aging. Infants are less likely to be exposed to a wide range of medications, reducing their risk. People with diabetes and women of childbearing age may have specific nutrient needs or considerations, but they are not typically at a higher risk for drug-nutrient interactions compared to older adults.

2. The nurse enters a client’s room and the client is demanding release from the hospital. The nurse reviews the client’s record and notes that the client was admitted 2 days ago for treatment of an anxiety disorder, and the admission was voluntary. Which intervention should the nurse initiate first?

• A. Telephone the client’s family and have them persuade the client to stay
• B. Have the client read and sign all the appropriate self-discharge papers
• C. Explain to the client that he cannot leave because he asked for treatment
• D. Notify the client’s healthcare provider of the client’s stated intent to leave the hospital

Correct answer: D

Rationale: The correct intervention for the nurse to initiate first is to notify the client’s healthcare provider of the client’s intention to leave the hospital. This is important to ensure that the client’s care and safety are appropriately managed. Option A is incorrect as involving the family without proper assessment or intervention could violate the client's autonomy. Option B is incorrect because it does not involve the healthcare provider in the decision-making process. Option C is incorrect as it does not address the client's rights to make decisions about their own care.

3. A client is transferred from the emergency department to the locked psychiatric unit after attempting suicide by taking 200 acetaminophen (Tylenol) tablets. The client is now awake and alert but refuses to speak with the nurse. In this situation, the nurse’s first priority is to:

• A. Establish a rapport to foster trust
• B. Place the client in full restraints
• C. Try to communicate with the client in writing
• D. Ensure safety by initiating suicide precautions

Correct answer: D

Rationale: In this scenario, the nurse's highest priority should be to ensure the client's safety by initiating suicide precautions. Given the history of a suicide attempt by taking a large number of acetaminophen tablets, there is a high risk of further self-harm. Placing the client in full restraints without assessing the situation properly may escalate anxiety and hinder therapeutic communication. Trying to communicate with the client in writing could be an option but ensuring immediate safety takes precedence. Establishing rapport is essential for building trust and therapeutic relationship, but safety concerns must be addressed first in this critical situation.

4. The client is complaining of painful swallowing secondary to mouth ulcers. Which statement by the client indicates appropriate management?

• A. “I will brush my teeth with a soft-bristle toothbrush.”
• B. “I will rinse my mouth with Listerine mouthwash.”
• C. “I will swish my antifungal solution and then swallow.”
• D. “I will avoid spicy foods, tobacco, and alcohol.”

Correct answer: D

Rationale: The correct answer is D. Avoiding irritants like spicy foods, tobacco, and alcohol is crucial in managing mouth ulcers as they can further irritate the ulcers and delay healing. Choices A, B, and C could potentially worsen the condition. Brushing with a soft-bristle toothbrush may cause discomfort, rinsing with Listerine mouthwash can be too harsh on the ulcers, and swallowing antifungal solution is not recommended unless specified by a healthcare provider.

5. What is the best way to manage a patient's intake of dietary fiber?

• A. Increase intake gradually
• B. Increase intake suddenly
• C. Decrease intake abruptly
• D. Maintain a high intake

Correct answer: A

Rationale: The best way to manage a patient's intake of dietary fiber is to increase it gradually. This approach helps prevent gastrointestinal discomfort that may arise from a sudden increase in fiber intake. Choice B is incorrect because increasing intake suddenly can lead to digestive issues. Choice C is incorrect as decreasing fiber intake abruptly may not be necessary and can impact overall health. Choice D is incorrect as maintaining a high intake without considering the patient's current intake level can also cause digestive problems.

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