Nursing Elites

1. A nurse is caring for a client following a CVA and observes the client experiencing severe dysphagia. The nurse notifies the provider. Which of the following nutritional therapies will likely be prescribed?

• A. NPO until dysphagia subsides
• B. Supplements via nasogastric tube
• C. Initiation of total parenteral nutrition
• D. Soft residue diet

Correct answer: B

Rationale: In the scenario of severe dysphagia following a CVA, the client may have difficulty swallowing and require alternative nutritional support. Providing supplements via a nasogastric tube allows for the delivery of essential nutrients directly into the stomach, bypassing the swallowing difficulties. NPO (nothing by mouth) until dysphagia subsides may be too restrictive for the client's nutritional needs. Initiation of total parenteral nutrition is usually reserved for cases where enteral feeding is not possible or contraindicated. A soft residue diet may not be suitable for a client experiencing severe dysphagia.

2. A condition that often progresses to become type 2 diabetes mellitus is:

• A. type 1 diabetes mellitus
• B. high blood pressure
• C. chronic pancreatitis
• D. impaired glucose tolerance

Correct answer: D

Rationale: Impaired glucose tolerance is a pre-diabetic state characterized by higher than normal blood sugar levels. It is often associated with insulin resistance and can progress to type 2 diabetes mellitus. Type 1 diabetes mellitus (Choice A) is an autoimmune condition where the body attacks insulin-producing cells, leading to a lack of insulin production. High blood pressure (Choice B) and chronic pancreatitis (Choice C) are not directly linked to the progression to type 2 diabetes mellitus.

3. A client is being taught about following a low-cholesterol diet after coronary artery bypass grafting. Which of the following food choices reflects the client's understanding of these dietary instructions?

• A. Liver
• B. Milk
• C. BEANS
• D. Eggs

Correct answer: C

Rationale: Choosing beans as a food option indicates that the client understands the low-cholesterol diet instructions. Beans are a good source of fiber and plant-based protein, which can help lower cholesterol levels. On the other hand, liver and eggs are high in cholesterol and should be limited in a low-cholesterol diet. Milk, especially whole milk, can also be high in saturated fats and cholesterol, so it is not the best choice for a low-cholesterol diet.

4. A nurse provides discharge instructions to a client about the food items that interact with warfarin effectiveness. Which food item indicates that the teaching was effective?

• A. Cauliflower
• B. Zucchini
• C. Green beans
• D. Broccoli

Correct answer: A

Rationale: Cauliflower is high in vitamin K, which can interact with warfarin.

5. After a few hours in the Emergency Room, Mr. Dizon is admitted to the ward with an order of hourly monitoring of blood pressure. The nurse finds that the cuff is too narrow and this will cause the blood pressure reading to be:

• A. inconsistent
• B. low systolic and high diastolic
• C. higher than what the reading should be
• D. lower than what the reading should be

Correct answer: C

Rationale: Effective nursing care involves comprehensive assessments that address all aspects of a patient's condition, ensuring that interventions are appropriately targeted and outcomes are optimized.

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