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. In an extreme situation and when no other resident or intern is available, should a nurse receive telephone orders, the order has to be correctly written and signed by the physician within:

• A. 24 hours
• B. 36 hours
• C. 48 hours
• D. 12 hours

Correct answer: B

Rationale: In an extreme situation where no other resident or intern is available, if a nurse receives telephone orders, the order has to be correctly written and signed by the physician within 36 hours. This time frame ensures timely documentation and validation of the orders. Choice A (24 hours) is too short a period for busy physicians to fulfill the task. Choice C (48 hours) is too long and delays the incorporation of physician orders into the patient's care plan. Choice D (12 hours) may not provide enough time for the physician to review and sign the order, especially in situations where immediate attention is not required.

3. Sugar alcohols have anticariogenic properties and can protect the teeth by decreasing demineralization, enhancing remineralization, or increasing salivary flow, even in the presence of a fermentable carbohydrate. Name 3 sugar alcohols.

• A. Sorbitol
• B. Mannitol
• C. Xylitol
• D. Erythritol

Correct answer: D

Rationale: Sugar alcohols such as sorbitol, mannitol, and xylitol are commonly used in sugar-free products and have properties that help protect teeth from caries by promoting remineralization and increasing salivary flow. Erythritol is another common sugar alcohol used as a sweetener in various products, but it was not listed in the question.

4. Each statement regarding the correlation between vitamin D and sun exposure is accurate, except one. Which is the exception?

• A. The body can produce sufficient amounts of vitamin D from sunlight.
• B. UV radiation can convert a precursor of vitamin D to vitamin D3 by penetrating uncovered skin.
• C. Sunscreen blocks the formation of vitamin D3.
• D. By the age of 70 years, the skin generally produces vitamin D at only half the level it did at the age of 20 years.

Correct answer: C

Rationale: While UV radiation can penetrate uncovered skin and convert a precursor of vitamin D to vitamin D3, sunscreen does block the formation of vitamin D3. Sunscreen is recommended by dermatologists to prevent sunburn and reduce the risk of skin cancer. The other choices are correct: the body can produce sufficient vitamin D from sunlight, UV radiation can convert a precursor of vitamin D to vitamin D3, and skin generally produces less vitamin D as a person ages.

5. Which factor contributes to the development of bone diseases in patients with Chronic Kidney Disease (CKD) due to retention?

• A. Iron
• B. Sodium
• C. Potassium
• D. Phosphorus

Correct answer: D

Rationale: The correct answer is phosphorus. Retention of phosphorus in patients with Chronic Kidney Disease (CKD) contributes to the development of bone disorders, including osteodystrophy, because it disrupts the balance of calcium and phosphorus in the body. This imbalance leads to a variety of bone diseases. The other options - iron, sodium, and potassium - while important in the overall metabolic function, are not directly linked to the development of bone diseases in CKD patients due to retention.

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