Nursing Elites

1. A nurse is caring for four clients. The nurse should observe which of the following clients for a risk of vitamin B6 deficiency?

• A. A client who has cystic fibrosis
• B. A client who has chronic alcohol use disorder
• C. A client who takes phenytoin for a seizure disorder
• D. A client who is prescribed rifampin for tuberculosis

Correct answer: B

Rationale: Chronic alcohol use disorder can lead to vitamin B6 deficiency due to impaired absorption and increased excretion of the vitamin. While clients with cystic fibrosis may be at risk for fat-soluble vitamin deficiencies, such as vitamins A, D, E, and K, they are not specifically at high risk for vitamin B6 deficiency. Clients taking phenytoin are at risk for folate deficiency, not vitamin B6. Clients prescribed rifampin for tuberculosis are at risk for vitamin D deficiency, not vitamin B6.

2. After a client was taken off the ventilator following surgery, they have a nasogastric tube draining bile-colored liquids. Which nursing measure will provide the most comfort to the client?

• A. Allow the client to suck on ice chips
• B. Provide mints to freshen the breath
• C. Perform frequent oral care with a tooth sponge
• D. Swab the mouth with glycerin swabs

Correct answer: C

Rationale: Performing frequent oral care with a tooth sponge is the most appropriate nursing measure to provide comfort to a client with a nasogastric tube draining bile-colored liquids. This measure helps to maintain oral hygiene, prevent dryness, and enhance overall comfort. Allowing the client to suck on ice chips may not address oral hygiene needs, providing mints focuses more on breath freshness rather than comfort, and swabbing the mouth with glycerin swabs may not effectively address oral care needs.

3. A client with gastroesophageal reflux is receiving teaching from a nurse. Which statement by the client indicates a need for further teaching?

• A. I will avoid eating after supper.
• B. I can drink coffee throughout the day.
• C. I drink milk when I get heartburn.
• D. I should not eat foods made with chocolate.

Correct answer: B

Rationale: The correct answer is B. Drinking coffee throughout the day can aggravate gastroesophageal reflux symptoms. Choices A, C, and D are correct statements that can help manage gastroesophageal reflux by avoiding late-night eating, not consuming trigger foods like chocolate, and using milk for relief when experiencing heartburn.

4. A client underwent coronary artery bypass grafting and is learning about following a low-cholesterol diet. Which of the following food choices indicates the client's understanding of these dietary instructions?

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

Correct answer: C

Rationale: The correct answer is C: Beans. Beans are an excellent choice for individuals following a low-cholesterol diet post-coronary artery bypass grafting due to their low cholesterol content. Beans are high in fiber and protein, making them a heart-healthy option. Choice A, Liver, is high in cholesterol and should be avoided in a low-cholesterol diet. Choice B, Milk, contains cholesterol and saturated fats, which are not ideal for this diet. Choice D, Eggs, are also high in cholesterol and should be limited in a low-cholesterol diet.

5. A middle-aged woman talks to the nurse in the healthcare provider's office about uterine fibroids, also called leiomyomas or myomas. What statement by the woman indicates more education is needed?

• A. I am one of every 4 women that get fibroids, and among women my age - between the 30s or 40s, fibroids occur more frequently.
• B. My fibroids are noncancerous tumors that grow slowly.
• C. The associated problems I have had are pelvic pressure and pain, urinary incontinence, frequent urination, urine retention, and constipation.
• D. Fibroids that cause no problems still need to be taken out.

Correct answer: D

Rationale: The correct answer is D because fibroids that are asymptomatic usually do not require treatment or removal. The statement 'Fibroids that cause no problems still need to be taken out' indicates a need for further education. Choice A correctly states the frequency of fibroids in women and their age group. Choice B accurately describes fibroids as noncancerous slow-growing tumors. Choice C lists common symptoms associated with uterine fibroids.

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