Nursing Elites

1. A client is being taught about foods to include in a low-fiber diet. Which statement indicates the client understands the teaching?

• A. "A fresh pear would be a good snack option."?
• B. "I can prepare refried beans for supper."?
• C. "Bran cereal would be a good breakfast choice."?
• D. "I should choose white rice as a side dish."?

Correct answer: D

Rationale: The correct answer is "I should choose white rice as a side dish." In a low-fiber diet, foods that are low in fiber are recommended to reduce gastrointestinal irritation. White rice is a low-fiber option suitable for this diet. Choices A, B, and C are high-fiber options and not suitable for a low-fiber diet. A fresh pear, refried beans, and bran cereal are all high in fiber, which should be avoided in a low-fiber diet.

2. You are taking care of critically ill client and the doctor in charge calls to order a DNR (do not resuscitate) for the client. Which of the following is the appropriate action when getting DNR order over the phone?

• A. Have the registered nurse, family spokesperson, nurse supervisor and doctor sign
• B. Have 2 nurse validate the phone order, both nurses sign the order and the doctor should sign his order within 24
• C. Have the registered nurse, family and doctor sign the order
• D. Have 1 nurse take the order and sign it and have the doctor sign it within 24 hours

Correct answer: A

Rationale: Patient safety and efficacy of care depend on actions rooted in established nursing protocols that consider both the immediate and long-term needs of the patient.

3. A client receiving total parenteral nutrition (TPN) suddenly develops tremors, dizziness, and diaphoresis. The client said, 'I feel weak and the bag was empty.' Which is the most likely complication the client is currently experiencing?

• A. Fluid volume overload
• B. Sepsis
• C. Hyperglycemia
• D. Hypoglycemia

Correct answer: D

Rationale: The client experiencing tremors, dizziness, diaphoresis, weakness, and stating that the TPN bag is empty is likely experiencing hypoglycemia. Hypoglycemia can occur when the TPN infusion suddenly stops, leading to a rapid drop in blood sugar levels. Symptoms of hypoglycemia include tremors, dizziness, diaphoresis, and weakness. Choices A, B, and C are incorrect as the symptoms presented are more consistent with hypoglycemia rather than fluid volume overload, sepsis, or hyperglycemia.

4. Studies suggest that leukoplakia is resolved by excess vitamin A (a fat-soluble vitamin), retinoids, and beta-carotene. Leukoplakia is a white plaque that forms on oral mucous membranes.

• A. Both statements are true.
• B. Both statements are false.
• C. The first statement is true; the second is false.
• D. The first statement is false; the second is true.

Correct answer: B

Rationale: Both statements are false. Studies suggest that leukoplakia, a white plaque that forms on oral mucous membranes, can be resolved by vitamin A, retinoids, and beta-carotene. Despite the potential to resolve leukoplakia, relapse is common. Also pertinent, evidence does not indicate that any of these nutrients prevent malignant transformation. The extract provided clarifies that leukoplakia is a white plaque, not an erythematous lesion, and that vitamin A, retinoids, and beta-carotene can help resolve it.

5. How is an ear infection that persists for less than 14 days classified?

• A. Mastoiditis
• B. Chronic Ear Infection
• C. Acute Ear Infection
• D. Otitis Media

Correct answer: C

Rationale: Acute Ear Infection is the correct answer because it typically refers to an infection that is short-lived and often severe, typically lasting less than 14 days. Chronic Ear Infection (Choice B) is incorrect as it refers to an ear infection that lasts for a long time or recurs often, typically more than three months. Mastoiditis (Choice A) is a complication of a middle ear infection and not an ear infection itself. Otitis Media (Choice D) is a general term for inflammation or infection in the middle ear, which can be either acute or chronic, so it's not specific enough to be the correct answer. Understanding the duration and severity of symptoms can help in identifying the type of ear infection, facilitating appropriate treatment and prevention of complications.

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