Nursing Elites

1. A client who has chronic lymphocytic leukemia is starting chemotherapy treatments and asks if she needs to make any dietary changes. Which of the following statements should the nurse make?

• A. "You should avoid drinking liquids an hour before the treatments."?
• B. "Eating low-calorie foods helps prevent nausea."?
• C. "Foods that are higher in fat are usually more appealing."?
• D. "Raw fruits and vegetables will be easier for your body to digest."?

Correct answer: D

Rationale: During chemotherapy treatments for chronic lymphocytic leukemia, raw fruits and vegetables are recommended as they are easier for the body to digest. This choice provides essential nutrients and is gentle on the digestive system. Option A is incorrect because staying hydrated is crucial during chemotherapy. Option B is incorrect as low-calorie foods may not provide sufficient energy during treatment. Option C is incorrect because high-fat foods are not typically recommended due to potential digestive issues.

2. Symptoms of irritable bowel syndrome are most likely associated with disturbed defecation, bloating, and _____.

• A. rectal bleeding
• B. abdominal pain
• C. rectal fissures
• D. esophageal paralysis

Correct answer: B

Rationale: Abdominal pain is a common symptom of irritable bowel syndrome (IBS), along with bloating and changes in bowel habits. Rectal bleeding (choice A) is more commonly associated with conditions like inflammatory bowel disease or colorectal cancer. Rectal fissures (choice C) may cause rectal bleeding but are not typically considered a core symptom of IBS. Esophageal paralysis (choice D) is unrelated to the symptoms of IBS, which primarily affect the lower gastrointestinal tract.

3. After a vaginal examination, the nurse determines that the client’s fetus is in an occiput posterior position. The nurse would anticipate that the client will have:

• A. A precipitous birth
• B. Intense back pain
• C. Frequent leg cramps
• D. Nausea and vomiting

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.

4. Medication for treating high blood cholesterol levels should not be used for most people unless:

• A. The patient has at least three major risk factors for coronary heart disease
• B. The patient has been experiencing symptoms of coronary heart disease for at least three months
• C. The patient's medical insurance covers prescription drugs
• D. Treatment with Therapeutic Lifestyle Changes (TLC) alone is unsuccessful after three months

Correct answer: D

Rationale: The correct answer is choice D because medication for high cholesterol is typically not considered unless Therapeutic Lifestyle Changes (TLC), which include diet and exercise, have not proven effective after a three-month period. This approach ensures that lifestyle modifications are given a fair chance to lower cholesterol levels before resorting to medication. Choice A is incorrect because the number of risk factors for coronary heart disease does not dictate when to begin medication; it is about the effectiveness of lifestyle changes. Choice B is incorrect as the duration of coronary heart disease symptoms does not determine when to start medication; the focus is on the response to TLC. Choice C is incorrect because the coverage of prescription drugs by the patient's insurance does not influence the medical decision to use medication for high cholesterol; it is based on medical necessity and effectiveness of prior interventions.

5. A nurse is providing dietary teaching to a client who has a new diagnosis of gastroesophageal reflux disease. Which of the following foods or beverages should the nurse recommend to minimize heartburn?

• A. Orange juice
• B. Decaffeinated coffee
• C. Peppermint
• D. Potatoes

Correct answer: D

Rationale: Potatoes are bland and less likely to relax the lower esophageal sphincter, making them a suitable choice to minimize heartburn in clients with gastroesophageal reflux disease. Orange juice and peppermint are acidic and can exacerbate GERD symptoms, while coffee, even decaffeinated, can stimulate acid production and worsen heartburn.

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