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 are sheets/forms that provide an efficient and time-saving way to record information that must be obtained repeatedly at regular and/or short intervals of time? This does not replace progress notes; instead, it records information on vital signs, intake and output, treatment, postoperative care, postpartum care, and diabetic regimen, etc. These are used whenever specific measurements or observations need to be documented repeatedly. What is this?

• A. Nursing Kardex
• B. Graphic Flow Sheets
• C. Discharge Summary
• D. Medicine and Treatment Record

Correct answer: A

Rationale: The correct answer is A, Nursing Kardex. Nursing Kardex is a tool used for documenting essential patient information that needs to be recorded repeatedly at regular intervals. It includes vital signs, intake and output, treatment details, postoperative care, postpartum care, and diabetic regimen. This tool is efficient and time-saving for healthcare professionals. Choice B, Graphic Flow Sheets, may be used for visual representation of patient data but is not specifically designed for repeated documentation of essential information. Choice C, Discharge Summary, is a document outlining the patient's care and condition at the time of discharge, not for repeated recording of ongoing data. Choice D, Medicine and Treatment Record, focuses more on specific medications and treatments rather than a comprehensive recording of various patient data needed at regular intervals.

3. A nurse is preparing a teaching plan for a client who has neutropenia as a result of radiation therapy for the treatment of lung cancer. Which of the following should the nurse plan to include in the teaching?

• A. Bottled water is an appropriate choice to increase fluid intake.
• B. The salad bar is a healthy choice when dining out.
• C. Soft-boiled eggs are an appropriate source of protein.
• D. Eating at a buffet is a good choice to increase caloric intake.

Correct answer: A

Rationale: In neutropenia, which is a low count of neutrophils, the client is at a high risk of infection. It is crucial to emphasize the importance of proper hydration to maintain overall health. Bottled water is a safe choice as it reduces the risk of exposure to contaminants that could further compromise the client's immune system. The other options, like the salad bar, soft-boiled eggs, and eating at a buffet, may not be suitable for a client with neutropenia due to the risk of bacterial contamination or exposure to pathogens that could lead to infections, which should be avoided.

4. Which medical problem is not generally associated with malnutrition?

• A. incontinence
• B. pressure sores
• C. celiac disease
• D. major surgery

Correct answer: A

Rationale: Incontinence is not typically associated with malnutrition, whereas conditions like pressure sores and celiac disease are directly linked to nutritional deficiencies and malabsorption.

5. Which of the following nutrients deficiency may lead to a diabetes-like condition?

• A. chromium
• B. iron
• C. molybdenum
• D. selenium

Correct answer: A

Rationale: Chromium is essential for proper glucose metabolism. A deficiency in chromium can result in insulin resistance, which shares similarities with diabetes. Iron, molybdenum, and selenium deficiencies do not directly lead to a diabetes-like condition. Iron deficiency causes anemia, molybdenum deficiency is rare and can lead to specific metabolic issues, and selenium deficiency may result in thyroid problems but not a diabetes-like condition.

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