Nursing Elites

1. A client with atrial fibrillation is prescribed warfarin (Coumadin). The nurse should reinforce which dietary instruction?

• A. Avoid foods high in vitamin K.
• B. Increase intake of dairy products.
• C. Limit intake of foods high in fiber.
• D. Increase protein intake.

Correct answer: A

Rationale: The correct answer is to avoid foods high in vitamin K. Clients taking warfarin (Coumadin) should maintain a consistent intake of vitamin K to keep the medication's effectiveness stable. Foods high in vitamin K, such as leafy greens, can interfere with the anticoagulant effects of warfarin. Therefore, it is crucial for clients to avoid these foods to ensure the therapeutic effects of warfarin. Choices B, C, and D are incorrect because increasing dairy products, limiting fiber intake, or increasing protein intake do not directly impact the effectiveness of warfarin therapy and are not necessary dietary modifications for clients on this medication.

2. When assessing a client receiving total parenteral nutrition (TPN), which laboratory value is most important for the nurse to monitor regularly?

• A. Albumin
• B. Calcium
• C. Glucose
• D. Alkaline phosphatase

Correct answer: C

Rationale: The most important laboratory value to monitor regularly in clients receiving total parenteral nutrition (TPN) is glucose. TPN solutions contain high concentrations of glucose, which can lead to hyperglycemia. Monitoring glucose levels is crucial to detect and prevent hyperglycemia, a common complication associated with TPN administration. Albumin (Choice A) levels are not typically affected by TPN administration. Calcium (Choice B) and alkaline phosphatase (Choice D) are not directly impacted by TPN and are not the primary values to monitor in TPN therapy.

3. A client with a history of coronary artery disease (CAD) is being discharged with a prescription for aspirin. Which instruction should the nurse reinforce with the client?

• A. Take the aspirin on an empty stomach for better absorption.
• B. Stop taking the aspirin if you experience any stomach discomfort.
• C. Take the aspirin with food to reduce the risk of stomach irritation.
• D. Take the aspirin only when you have chest pain.

Correct answer: C

Rationale: The correct instruction is to take the aspirin with food to reduce the risk of stomach irritation. This is crucial for clients with a history of coronary artery disease as it helps minimize gastrointestinal side effects like irritation and bleeding. Option A is incorrect because aspirin should not be taken on an empty stomach to prevent stomach upset. Option B is incorrect because discontinuing aspirin at the first sign of stomach discomfort can be harmful, and a healthcare provider should be consulted instead. Option D is incorrect because aspirin is often prescribed for prevention in cardiovascular conditions, not just for chest pain relief.

4. When reinforcing dietary instructions to a client with coronary artery disease prescribed a low-fat, low-cholesterol diet, which food item should the nurse advise the client to choose?

• A. Whole milk
• B. Grilled salmon
• C. Fried chicken
• D. Bacon and eggs

Correct answer: B

Rationale: Grilled salmon is the correct choice for a client with coronary artery disease on a low-fat, low-cholesterol diet because it is low in saturated fat and high in omega-3 fatty acids, which are beneficial for heart health. Whole milk, fried chicken, and bacon and eggs are higher in saturated fats and cholesterol, making them less suitable choices for this client. Whole milk is high in saturated fat, while fried chicken and bacon and eggs are sources of both saturated fat and cholesterol, which can negatively impact heart health in clients with coronary artery disease.

5. A client diagnosed with thrombophlebitis 1 day ago suddenly complains of chest pain and shortness of breath. The LPN/LVN understands that a life-threatening complication of this condition is which?

• A. Pneumonia
• B. Pulmonary edema
• C. Pulmonary embolism
• D. Myocardial infarction

Correct answer: C

Rationale: The correct answer is C, Pulmonary embolism. Pulmonary embolism is a critical complication of thrombophlebitis where a blood clot dislodges and travels to the lungs, obstructing blood flow. This obstruction can lead to chest pain, shortness of breath, and potentially fatal consequences, making it a life-threatening emergency that requires prompt intervention. Choices A, B, and D are incorrect because pneumonia, pulmonary edema, and myocardial infarction are not directly associated with thrombophlebitis and would not present with the sudden onset of chest pain and shortness of breath in this context.

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