Nursing Elites

1. The nurse is caring for a client taking warfarin. Which meal brought in by the client's family is a priority to remove before the client eats it?

• A. Oriental cabbage salad with chicken
• B. Beef enchilada, rice, and beans
• C. Ham and cheese sandwich
• D. Macaroni salad and grapefruit slices

Correct answer: C

Rationale: The correct answer is C. Ham is high in vitamin K, which can interfere with warfarin. Vitamin K can decrease the effectiveness of warfarin, an anticoagulant medication. Choices A, B, and D do not contain high levels of vitamin K and are less likely to interfere with the client's warfarin therapy.

2. Which systemic disease is best controlled with the DASH diet, monitoring blood pressure, limiting sodium, alcohol, and caffeine, reducing stress, and losing weight?

• A. Hypertension
• B. Diabetes mellitus
• C. Parkinson's disease
• D. Anemia

Correct answer: A

Rationale: The correct answer is A: Hypertension. The DASH diet is specifically designed to control hypertension by reducing sodium intake, managing blood pressure, and promoting overall cardiovascular health. Choice B, Diabetes mellitus, is managed through monitoring blood sugar levels and a balanced diet rich in whole grains, fruits, and vegetables. Choice C, Parkinson's disease, is a neurological disorder that is not primarily managed through diet modifications. Choice D, Anemia, is a condition characterized by a lack of healthy red blood cells and is typically managed by addressing the underlying cause and sometimes iron supplementation, not by the methods mentioned in the question.

3. What is the term for a barrier that prevents the normal emptying of stomach contents into the duodenum?

• A. Dumping syndrome
• B. Gastritis
• C. Gastric outlet obstruction
• D. Hypochlorhydria

Correct answer: C

Rationale: Gastric outlet obstruction refers to a condition where the opening between the stomach and the duodenum is blocked, preventing the normal passage of food. This is why choice 'C' is correct. 'A: Dumping syndrome' is incorrect because it is a condition where stomach contents move too quickly through the small intestine, not a barrier preventing emptying. 'B: Gastritis' is inflammation of the stomach lining, not a blockage of the outlet. 'D: Hypochlorhydria' refers to low stomach acid, which may affect digestion but does not create a physical barrier blocking the outlet of the stomach.

4. After cleaning the abrasions and applying antiseptic, the nurse applies a cold compress to the swollen ankle as ordered by the physician. This statement shows that the nurse has a correct understanding of the use of a cold compress:

• A. Cold compress reduces blood viscosity in the affected area
• B. It is safer to apply than a hot compress
• C. Cold compress prevents edema and reduces pain
• D. It eliminates toxic waste products due to vasodilation

Correct answer: C

Rationale: The correct understanding of using a cold compress includes knowing that it helps prevent edema and reduces pain. Cold application constricts blood vessels, reducing blood flow to the area, which helps decrease swelling and pain. Choices A, B, and D are incorrect because cold compresses do not directly affect blood viscosity, safety compared to hot compresses, or eliminate toxic waste products due to vasodilation. It is essential for nurses to have a clear understanding of the rationale behind interventions to provide effective patient care.

5. Which is most likely to initiate periodontal disease?

• A. Nutrient deficiencies
• B. Nutrient excesses
• C. Nutrient imbalances
• D. Plaque biofilm

Correct answer: D

Rationale: Plaque biofilm is the primary initiator of periodontal disease, as it harbors bacteria that can lead to inflammation and destruction of the periodontal tissues.

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