Nursing Elites

1. Which of the following grains is acceptable for someone with celiac disease?

• A. Rice
• B. Rye
• C. Wheat
• D. Barley

Correct answer: A

Rationale: The correct answer is A, Rice. Rice is a gluten-free grain and is safe for individuals with celiac disease. Rye, wheat, and barley contain gluten, which can trigger adverse reactions in individuals with celiac disease. Therefore, choices B, C, and D are incorrect for someone with this condition.

2. Which nursing instruction should the nurse discuss with the client who is receiving glucocorticoids for Addison’s disease?

• A. Discuss the importance of tapering medications when discontinuing medication
• B. Explain that the dose will need to be decreased during times of stress or infection
• C. Instruct the client to take medication on an empty stomach with a glass of water
• D. Encourage the client to wear a MedicAlert bracelet and carry a card in the wallet

Correct answer: A

Rationale: The correct answer is to discuss the importance of tapering medications when discontinuing medication. Tapering glucocorticoids is crucial to prevent adrenal insufficiency, which can occur if the medication is stopped abruptly. Choice B is incorrect because it focuses on adjustments during stress or infection, not discontinuation. Choice C is unrelated to the management of glucocorticoids. Choice D is important for emergency identification but is not directly related to medication management.

3. A client has been given instructions about ferrous sulfate. Which statement made by the client would indicate the client needs further education?

• A. I will take this medication on an empty stomach.
• B. I will take the morning dose 1 hour before breakfast.
• C. I will need to avoid taking this medication with coffee.
• D. I will take antacids if needed, 2 hours after I take ferrous sulfate.

Correct answer: A

Rationale: The correct answer is A. Ferrous sulfate should be taken on an empty stomach to improve absorption. Choice A is incorrect as taking the medication with a full glass of milk would impair iron absorption. Choices B, C, and D are all correct statements regarding the administration of ferrous sulfate. Choice B ensures proper timing before breakfast, choice C highlights avoiding coffee due to interference with iron absorption, and choice D correctly suggests taking antacids a few hours after ferrous sulfate to prevent potential interactions.

4. The nurse is caring for the client recovering from a percutaneous renal biopsy. Which data indicate that the client is complying with client teaching?

• A. The client lies flat in the supine position for 12 hours
• B. The client continues oral fluids restriction while on bed rest
• C. The client’s family changed the dressing on return to the room
• D. The family activates the patient-controlled analgesia pump

Correct answer: A

Rationale: The correct answer is A. Lying flat in the supine position for 12 hours after a renal biopsy is essential to prevent bleeding and promote recovery. This position helps apply pressure to the biopsy site, reducing the risk of bleeding. Choices B, C, and D are incorrect because continuing oral fluids restriction, changing the dressing, and activating the patient-controlled analgesia pump do not directly indicate compliance with the crucial post-biopsy teaching of maintaining the supine position.

5. The client diagnosed with acute vein thrombosis is receiving a continuous heparin drip, an intravenous anticoagulant. The health care provider orders warfarin (Coumadin), an oral anticoagulant. Which action should the nurse take?

• A. Discontinue the heparin drip before initiating the Coumadin
• B. Check the client’s INR before beginning Coumadin
• C. Clarify the order with the healthcare provider as soon as possible
• D. Administer the Coumadin along with the heparin drip as ordered

Correct answer: D

Rationale: The correct answer is to administer the Coumadin along with the heparin drip as ordered. Heparin and warfarin are often given together initially because warfarin takes a few days to become effective. Discontinuing the heparin drip before initiating Coumadin can increase the risk of clot formation. Checking the client's INR before starting Coumadin is important but not the immediate action required. Clarifying the order with the healthcare provider is not necessary as both medications are commonly used together.

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