Nursing Elites

1. Which meal should be removed for a client taking warfarin?

• 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 meal to remove for a client taking warfarin is the 'Ham and cheese sandwich.' Ham is high in vitamin K, which can interfere with the effectiveness of warfarin, a medication that works by decreasing the clotting ability of the blood. Vitamin K can counteract the effects of warfarin by promoting blood clotting. Choices A, B, and D do not contain high amounts of vitamin K and are therefore safer options for individuals taking warfarin.

2. Low levels of high-density lipoproteins (HDL) are?

• A. associated with being underweight
• B. more prevalent in males
• C. highly predictive of CHD risk
• D. not a good predictor of CHD risk

Correct answer: C

Rationale: Low levels of HDL cholesterol are a strong predictor of coronary heart disease (CHD) risk because HDL helps to remove excess cholesterol from the bloodstream. Choice A is incorrect because low HDL levels are not associated with being underweight but rather with increased CHD risk. Choice B is incorrect as low HDL levels are not more prevalent in males but can affect both genders. Choice D is incorrect as low levels of HDL are indeed a good predictor of CHD risk.

3. Which team member works with the client to evaluate the need for special feeding devices and then teaches the client how to use the device?

• A. dietitian
• B. speech-language pathologist
• C. dietetic technician
• D. occupational therapist

Correct answer: D

Rationale: An occupational therapist is the team member who works with the client to evaluate the need for special feeding devices and teaches the client how to use them. Occupational therapists specialize in helping individuals with physical or cognitive impairments to perform daily activities. In this scenario, the need for special feeding devices may be due to impaired motor function or disability, making the occupational therapist the correct choice. The other options, dietitian, speech-language pathologist, and dietetic technician, do not typically specialize in evaluating the need for feeding devices or teaching clients how to use them.

4. A nurse is caring for a client who is receiving parenteral nutrition. Which of the following findings indicates the therapy is effective?

• A. Client has soft, formed bowel movements.
• B. Client’s mucous membranes are pink.
• C. Client reports ability to complete ADLs.
• D. Client’s blood glucose level is within the expected reference range.

Correct answer: D

Rationale: The correct answer is D because having a blood glucose level within the expected reference range indicates that parenteral nutrition is effectively meeting the client's nutritional needs. Choices A, B, and C are incorrect because soft, formed bowel movements, pink mucous membranes, and the ability to complete activities of daily living do not directly reflect the effectiveness of parenteral nutrition therapy.

5. Which hormone is produced in fat tissue and helps regulate body fat by suppressing appetite?

• A. glucagon
• B. ghrelin
• C. leptin
• D. insulin

Correct answer: C

Rationale: The correct answer is C, leptin. Leptin is a hormone produced by fat cells that helps regulate energy balance by suppressing hunger, thus aiding in the regulation of body fat. Glucagon (choice A) is a hormone that raises blood glucose levels, ghrelin (choice B) stimulates appetite, and insulin (choice D) regulates blood sugar levels and promotes glucose uptake.

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