Nursing Elites

1. A nurse is assisting with meal planning for a client who has been prescribed a mechanical soft diet. The nurse should instruct the client to avoid which of the following foods?

• A. Applesauce
• B. Mashed potatoes
• C. Orange slices
• D. Soft bread

Correct answer: C

Rationale: The correct answer is C: Orange slices. Orange slices contain membranes that are difficult to swallow, which can pose a risk to clients on a mechanical soft diet. This type of diet is designed for individuals who have difficulty chewing or swallowing. Choices A, B, and D are suitable for a mechanical soft diet as they are soft in texture and easy to chew and swallow.

2. A healthcare provider is assessing a client who is receiving heparin therapy for deep vein thrombosis (DVT). Which of the following laboratory values should the provider monitor to evaluate the therapeutic effect of the heparin?

• A. Platelet count
• B. Partial thromboplastin time (PTT)
• C. Prothrombin time (PT)
• D. Bleeding time

Correct answer: B

Rationale: The Partial Thromboplastin Time (PTT) is the correct laboratory value to monitor heparin therapy. PTT measures the time it takes for blood to clot and is specifically used to evaluate the effectiveness of anticoagulation therapy such as heparin. Monitoring the PTT helps ensure that the heparin dose is within the therapeutic range. Platelet count, Prothrombin time (PT), and Bleeding time are not specific laboratory values for monitoring the therapeutic effect of heparin therapy. Platelet count is more indicative of platelet function, PT is used to monitor warfarin therapy, and Bleeding time assesses platelet function rather than the effect of heparin therapy.

3. A nurse is educating a client about caloric intake and weight reduction. Which of the following client statements indicates an understanding of the teaching?

• A. If I eat 500 fewer calories per day, I should lose 1 pound per week.
• B. If I eat 450 fewer calories per day, I should lose 2 pounds per week.
• C. If I eat 250 fewer calories per day, I should lose 2 pounds per week.
• D. If I eat 300 fewer calories per day, I should lose 1 pound per week.

Correct answer: A

Rationale: The correct answer is A: 'If I eat 500 fewer calories per day, I should lose 1 pound per week.' This statement is accurate because a reduction of 500 calories per day typically results in a weight loss of 1 pound per week. This is based on the principle that a calorie deficit of 3,500 calories equals about 1 pound of body fat. Choices B, C, and D are incorrect because they do not align with the established relationship between calorie reduction and weight loss. Eating 450 fewer calories per day would not lead to a weight loss of 2 pounds per week; similarly, reducing calories by 250 or 300 per day would not result in losing 2 pounds or 1 pound per week, respectively.

4. A client who gave birth 12 hours ago is experiencing excessive vaginal bleeding. Which of the following findings indicates the client is experiencing decreased cardiac output?

• A. Bradycardia
• B. Flushed face
• C. Hypotension
• D. Polyuria

Correct answer: C

Rationale: Hypotension is a key indicator of decreased cardiac output, especially in the context of postpartum hemorrhage, which can lead to significant fluid volume loss and compromise perfusion. In this scenario, the excessive vaginal bleeding could lead to hypovolemia, resulting in decreased cardiac output and subsequent hypotension. Bradycardia (choice A) is not typically associated with decreased cardiac output in this scenario, as the body often compensates for decreased cardiac output by increasing heart rate. A flushed face (choice B) may indicate vasodilation but is not a direct indicator of decreased cardiac output. Polyuria (choice D) is excessive urination and is not a specific indicator of decreased cardiac output in this context.

5. A laboring client received meperidine IV one hour prior to delivery. Which of the following medications should the nurse have available to counteract the effects of this medication on the newborn?

• A. Naloxone
• B. Epinephrine
• C. Atropine
• D. Diazepam

Correct answer: A

Rationale: Meperidine is an opioid analgesic that can cross the placenta and cause respiratory depression in the newborn. Naloxone is an opioid antagonist that is administered to reverse the effects of opioids. It is critical to have Naloxone available when opioids are administered during labor, especially close to delivery. Epinephrine is not used to counteract the effects of opioids but rather for managing severe allergic reactions or cardiac arrest. Atropine is used for specific conditions like bradycardia, not to counteract opioid effects. Diazepam is a benzodiazepine used for anxiety, seizures, and muscle spasms, not for reversing opioid effects.

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