Nursing Elites

1. When discussing dietary preferences with a client adhering to a vegan diet, which dietary supplement should the nurse encourage the client to include in the dietary plan?

• A. Fiber
• B. Folate
• C. Ascorbic acid
• D. Vitamin B12

Correct answer: D

Rationale: Vitamin B12 is an essential nutrient predominantly found in animal products. Individuals following a vegan diet, which excludes animal products, are at a higher risk of vitamin B12 deficiency. Encouraging the client to include a vitamin B12 supplement in their dietary plan is crucial to prevent deficiency-related health issues. Choices A, B, and C are not specific to addressing the deficiency that vegan diets may cause. Fiber, folate, and ascorbic acid are important but do not directly address the risk of vitamin B12 deficiency in vegan diets.

2. The healthcare provider who is preparing to give an adolescent client a prescribed antipsychotic medication notes that parental consent has not been obtained. Which action should the provider take?

• A. Review the chart for a signed consent for medication administration.
• B. Obtain parental consent before giving the medication.
• C. Do not give the medication and document the reason.
• D. Complete an incident report and notify the adolescent.

Correct answer: C

Rationale: The correct action is for the provider not to administer the medication and to document the reason. In the case of a minor, parental consent is required for medical treatment, including medication administration. It is important to follow legal and ethical guidelines to ensure the adolescent's well-being and rights are protected. Choice A is incorrect because simply reviewing the chart does not address the lack of parental consent. Choice B is incorrect as obtaining parental consent should be done before medication administration. Choice D is incorrect as notifying the adolescent is not the appropriate action in this situation, as parental consent is legally required for a minor's medical treatment.

3. During a home visit, an elderly female client who had a brain attack three months ago and can now ambulate with a quad cane is assessed by the nurse. Which assessment finding has the greatest implications for this client's care?

• A. The husband, who is the caregiver, begins to weep when the nurse asks how he is doing.
• B. The client tells the nurse that she does not have much of an appetite today.
• C. The nurse notes that there are numerous scatter rugs throughout the house.
• D. The client's pulse rate is 10 beats higher than it was at the last visit one week ago.

Correct answer: C

Rationale: The presence of numerous scatter rugs throughout the house poses a significant safety hazard to the client who is ambulating with a quad cane. These rugs increase the risk of tripping and falling, making it the most critical finding that needs immediate attention to prevent potential injuries and ensure the client's safety during ambulation.

4. The healthcare provider is teaching a client with hypertension about lifestyle modifications. Which instruction should the healthcare provider include?

• A. Limit sodium intake to 2,300 mg per day
• B. Engage in moderate exercise for 30 minutes daily
• C. Consume a diet high in saturated fats
• D. Avoid alcohol consumption completely

Correct answer: B

Rationale: Engaging in moderate exercise for 30 minutes daily is a crucial lifestyle modification for managing hypertension. Regular physical activity helps lower blood pressure, improve cardiovascular health, and overall well-being. It is recommended to engage in activities like brisk walking, cycling, or swimming to achieve these benefits. Choices A, C, and D are incorrect. Limiting sodium intake, avoiding a diet high in saturated fats, and reducing alcohol consumption are also important lifestyle modifications for hypertension management, but engaging in moderate exercise is the most appropriate initial instruction for this client.

5. A client with a history of coronary artery disease (CAD) is admitted with chest pain. Which intervention should the nurse implement first?

• A. Administer sublingual nitroglycerin
• B. Obtain a 12-lead electrocardiogram (ECG)
• C. Apply oxygen via nasal cannula
• D. Initiate continuous cardiac monitoring

Correct answer: C

Rationale: In a client with a history of coronary artery disease (CAD) experiencing chest pain, the priority intervention for the nurse to implement first is to apply oxygen via nasal cannula. Oxygenation is crucial to ensure adequate oxygen supply to the tissues and the heart. This intervention takes precedence over administering sublingual nitroglycerin, obtaining an ECG, or initiating continuous cardiac monitoring. While these interventions are important, ensuring adequate oxygenation is the initial priority in the management of a client with chest pain.

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