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. You are on duty in the medical ward. You were asked to check the narcotics cabinet. You found out that what is on record does not tally with the drugs used. What will you do first?

• A. Write an incident report and refer the matter to the nursing director
• B. Keep your findings to yourself
• C. Report the matter to your supervisor
• D. Find out from the endorsement any patient who might have been given narcotics

Correct answer: C

Rationale: In this situation, the first step should be to report the matter to your supervisor. It is essential to notify the appropriate authority immediately to address the discrepancy in the narcotics cabinet. Choice A is not the first step as reporting to the nursing director should follow after informing the supervisor. Keeping the findings to yourself (Choice B) is not appropriate as it may jeopardize patient safety and is against ethical standards. While finding out which patient received narcotics (Choice D) is important, it is not the immediate action to take in this scenario.

3. Which mineral is a principal component of cell membranes?

• A. phosphorus
• B. magnesium
• C. iron
• D. iodine

Correct answer: A

Rationale: Phosphorus is the correct answer. It is a key component of cell membranes, being part of the phospholipid bilayer that provides structure and controls the movement of substances in and out of cells. Magnesium, iron, and iodine do not serve as principal components of cell membranes. Magnesium is involved in various enzymatic reactions, iron is essential for oxygen transport, and iodine plays a role in thyroid hormone synthesis.

4. A nurse is reviewing blood glucose values for a client who is at risk for Diabetes Mellitus. Which of the following findings should the nurse report to the provider?

• A. 2-hour glucose tolerance test level 150 mg/dL
• B. Fasting blood glucose 70 mg/dL
• C. Glycosylated hemoglobin 5%
• D. Casual blood glucose 90 mg/dL

Correct answer: A

Rationale: The correct answer is A. A 2-hour glucose tolerance test level of 150 mg/dL is above the normal range and should be reported to the provider as it indicates impaired glucose tolerance. Choice B (Fasting blood glucose 70 mg/dL) is within the normal range. Choice C (Glycosylated hemoglobin 5%) is also within the normal range. Choice D (Casual blood glucose 90 mg/dL) is within the normal range and does not indicate impaired glucose tolerance.

5. Which enzyme initiates protein digestion in the stomach?

• A. Pepsin
• B. Salivary Amylase
• C. CCK
• D. Secretin

Correct answer: A

Rationale: Pepsin is the enzyme that initiates protein digestion in the stomach. It breaks down proteins into smaller peptides, aiding in their further digestion and absorption in the intestines. Salivary Amylase (Choice B) functions in breaking down dietary carbohydrates in the mouth, not proteins. CCK (Choice C) and Secretin (Choice D) are hormones involved in the digestion of fats and carbohydrates, not proteins. Therefore, Choices B, C, and D are incorrect in the context of protein digestion in the stomach.

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