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. What is the function of the gallbladder?

• A. to store bile
• B. to produce bile
• C. to digest bile
• D. to modify bile to a liquid form

Correct answer: A

Rationale: The correct answer is A: "to store bile." The gallbladder acts as a reservoir for bile produced by the liver. It releases bile into the small intestine to aid in the digestion of fats. Choice B is incorrect because the liver produces bile, not the gallbladder. Choice C is incorrect as the gallbladder does not digest bile but stores and releases it for digestion. Choice D is incorrect because bile is already in liquid form; the gallbladder does not modify it to a liquid state.

3. A nurse is providing teaching to an obese client who has gestational diabetes and is at 25 weeks of gestation. Which of the following statements made by the client indicates a need for further teaching?

• A. This does not mean that my baby will have this disease.
• B. This means that I will have diabetes for the rest of my life.
• C. If I feel dizzy, I should drink six ounces of a non-diet soda.
• D. Being obese might be one reason why I developed diabetes.

Correct answer: B

Rationale: The statement 'This means that I will have diabetes for the rest of my life' indicates a need for further teaching. Gestational diabetes often resolves after pregnancy, although it does indicate a higher risk for developing type 2 diabetes in the future. The other choices are correct or provide appropriate information: A) Understanding that gestational diabetes does not mean the baby will have the disease is accurate. C) Advising to drink non-diet soda if feeling dizzy is incorrect and potentially harmful due to the sugar content. D) Recognizing that obesity can be a risk factor for developing diabetes is a valid statement.

4. Which term is used to describe medical practices that have been thoroughly evaluated using scientific methods?

• A. Meta-analysis
• B. Systematic reviews
• C. Evidence-based
• D. Observational studies

Correct answer: C

Rationale: The correct answer is C, 'Evidence-based.' Evidence-based practices refer to medical practices that have been thoroughly evaluated and supported by scientific research. Meta-analysis (A) involves statistical analysis that combines the results of multiple studies. Systematic reviews (B) are comprehensive reviews that synthesize evidence from multiple studies. Observational studies (D) are research methods where researchers observe subjects in their natural environment.

5. Which of the following interventions should be considered the highest priority when caring for June, who has hemiparesis secondary to a stroke?

• A. Position June in an upright lateral position
• B. Perform range of motion exercises
• C. Apply antiembolic stockings
• D. Use hand rolls or pillows for support

Correct answer: C

Rationale: The correct answer is C, 'Apply antiembolic stockings'. In the case of a patient who has experienced a stroke and is suffering from hemiparesis, the highest priority intervention is to prevent further complications such as deep vein thrombosis (DVT), which can be life-threatening. Antiembolic stockings are used to increase venous blood flow velocity and reduce the risk of DVT. Choice 'A', positioning June in an upright lateral position, while important for overall care, is not the highest priority. Choice 'B', performing range of motion exercises, is an important part of recovery but not the immediate priority. Choice 'D', using hand rolls or pillows for support, is also a valuable intervention but does not address the most pressing risk of further complications.

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