Nursing Elites

1. Which client is most likely to need regular injections of vitamin B12?

• A. The client with malabsorption syndrome.
• B. The client following a vegan eating pattern.
• C. The client whose stomach does not produce intrinsic factors.
• D. The client with alcoholism.

Correct answer: C

Rationale: The correct answer is C. The client whose stomach does not produce intrinsic factors is most likely to need regular injections of vitamin B12. Intrinsic factor is essential for the absorption of vitamin B12. Without intrinsic factor, the client cannot absorb vitamin B12 from food, necessitating the need for regular injections. Choices A, B, and D do not directly impact the production of intrinsic factors in the stomach, so they are less likely to result in the need for vitamin B12 injections.

2. A client with cholecystitis is being taught about required dietary modifications. Which of the following foods is appropriate for the client's diet?

• A. Creamed chicken
• B. Roast turkey
• C. Ice cream
• D. Macaroni and cheese

Correct answer: B

Rationale: Roast turkey is the most appropriate choice for a client with cholecystitis. Foods that are high in fat content, like creamed chicken, ice cream, and macaroni and cheese, should be avoided in cholecystitis as they can exacerbate symptoms due to the reduced ability of the gallbladder to process fats. Roast turkey is a leaner option that is better tolerated by individuals with cholecystitis.

3. What dietary strategy would most likely be used as part of lifestyle management to reduce the risk of coronary heart disease?

• A. Avoid foods that contain polyunsaturated fat
• B. Limit saturated fat to less than 10 percent of total calories
• C. Limit alcohol intake to one drink daily for women and two drinks daily for men
• D. Avoid consumption of fish and shellfish

Correct answer: C

Rationale: Limiting alcohol intake is part of a strategy to reduce the risk of coronary heart disease by avoiding the negative cardiovascular effects associated with excessive alcohol consumption.

4. Which of the following vaccines is not done by intramuscular (IM) injection?

• A. Measles vaccine C. Hepa-B vaccine
• B. DPT D. Tetanus toxoids
• C.
• D.

Correct answer: D

Rationale: Understanding the underlying pathology and therapeutic techniques ensures that nursing care is not only reactive but also preventative, reducing the risk of complications.

5. A client receiving continuous enteral tube feeding reports cramping and abdominal distention. Which of the following actions should the nurse take?

• A. Check for gastric residual.
• B. Apply low intermittent suction.
• C. Increase the rate of the feeding.
• D. Request a higher-fat formula.

Correct answer: A

Rationale: When a client on continuous enteral tube feeding experiences cramping and abdominal distention, the nurse should check for gastric residual. This assessment helps determine if the client is tolerating the feeding well or if there is a potential issue such as feeding intolerance. Applying low intermittent suction, increasing the feeding rate, or requesting a higher-fat formula are not appropriate actions for addressing the reported symptoms and may exacerbate the client's discomfort or lead to further complications.

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