Nursing Elites

1. A client with Crohn's disease is receiving parenteral nutrition. Which of the following interventions should the nurse not include in the care of this client?

• A. Remove the parenteral nutrition solution from the refrigerator 2 hours before infusion.
• B. Remove unused parenteral nutrition after 12 hours of use.
• C. Monitor daily laboratory values and report abnormalities as needed.
• D. Monitor the flow rate of the parenteral nutrition carefully and adjust it if necessary.

Correct answer: B

Rationale: In caring for a client receiving parenteral nutrition, it is important to follow proper guidelines to ensure safety and effectiveness. Unused parenteral nutrition should be removed after 24 hours, not 12 hours, to prevent contamination and reduce the risk of infection. Option A is correct as it ensures the solution is at room temperature before infusion. Option C is essential for monitoring the client's response to parenteral nutrition. Option D is important to maintain the correct flow rate and adjust it as needed. Therefore, option B is the incorrect choice among the options provided.

2. Which food item interferes with the effectiveness of warfarin?

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

Correct answer: D

Rationale: Broccoli is high in vitamin K, which can affect the effectiveness of warfarin. Warfarin is an anticoagulant medication that functions by reducing the activity of vitamin K in the body. When one consumes broccoli, which is rich in vitamin K, it could counteract the anticoagulant effect of warfarin, thereby interfering with its effectiveness. On the other hand, cauliflower, zucchini, and green beans do not have significant levels of vitamin K and hence, are not known to impact the effectiveness of warfarin.

3. What is the most effective way to limit the number of microorganisms in the hospital?

• A. Using strict aseptic technique in all procedures
• B. Wearing a mask and gown when caring for all patients with communicable diseases
• C. Sterilizing all instruments
• D. Handwashing

Correct answer: A

Rationale: The most effective way to limit the number of microorganisms in the hospital is by using strict aseptic technique in all procedures. This approach ensures that the risk of introducing harmful microorganisms into the hospital environment or patients is minimized. Choice B, wearing a mask and gown when caring for patients with communicable diseases, is important but not as comprehensive as using aseptic technique in all procedures. Sterilizing all instruments (Choice C) is crucial for preventing infections but may not address all avenues of microorganism transmission. Handwashing (Choice D) is a fundamental practice in infection control but alone may not be as effective as utilizing aseptic techniques in all procedures to limit microorganisms in the hospital.

4. Which test is used to monitor the degree of blood glucose control over a long period?

• A. Glucose tolerance test
• B. Glycated hemoglobin level
• C. Self-monitoring of blood glucose
• D. 24-hour urinary glucose excretion

Correct answer: B

Rationale: The correct answer is B, glycated hemoglobin level. The glycated hemoglobin (HbA1c) test measures the average blood glucose levels over the past 2-3 months, providing a long-term picture of glucose control. Choice A, the glucose tolerance test, measures how well your body processes glucose but is not specifically for long-term monitoring. Choice C, self-monitoring of blood glucose, involves daily testing by individuals, providing immediate rather than long-term information. Choice D, 24-hour urinary glucose excretion, measures the amount of glucose excreted in the urine over 24 hours and is not typically used for long-term monitoring of blood glucose control.

5. What nursing diagnosis would be most appropriate for a patient with heart failure?

• A. risk for infection
• B. fluid volume excess
• C. impaired body temperature
• D. ineffective airway clearance

Correct answer: B

Rationale: The most appropriate nursing diagnosis for a patient with heart failure is 'fluid volume excess.' In heart failure, the heart's reduced pumping ability leads to fluid retention, causing an excess of fluid in the body. This can result in symptoms such as edema, shortness of breath, and weight gain. 'Risk for infection,' 'impaired body temperature,' and 'ineffective airway clearance' are not the most appropriate nursing diagnoses for a patient with heart failure as they do not directly relate to the pathophysiology and common issues seen in heart failure patients.

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