Nursing Elites

1. A nurse is planning care for a client who practices Islam and is currently observing dietary restrictions for the month of Ramadan. Which of the following interventions should the nurse include in the plan of care?

• A. Remove beef products from the dietary plan
• B. Facilitate fasting during daylight hours
• C. Serve meat and dairy items separately
• D. Provide a strictly vegetarian diet on Fridays

Correct answer: B

Rationale: Facilitating fasting during daylight hours respects the dietary practices of clients observing Ramadan.

2. A nurse is assessing a client who reports muscle spasms in his calves and tingling in his hands. The client indicates consuming a low intake of milk products and green leafy vegetables. The nurse should identify that the client's findings indicate a deficiency in which of the following sources of nutrition?

• A. Iron
• B. Omega 3 fatty acids
• C. Vitamin C
• D. Calcium

Correct answer: D

Rationale: Calcium deficiency is indicated by muscle spasms and tingling, and is common with low intake of milk products and green leafy vegetables.

3. A nurse is reviewing the laboratory findings of a client who has heart failure. Which of the following findings indicates that the client is experiencing fluid volume excess?

• A. BUN 8 mg/dL
• B. Hgb 15 g/dL
• C. Creatinine 0.8 mg/dL
• D. Sodium 140 mEq/L

Correct answer: A

Rationale: A BUN level of 8 mg/dL is indicative of fluid volume excess, which is common in clients with heart failure.

4. A nurse is initiating continuous enteral feedings for a client who has a new gastrostomy tube. Which of the following actions should the nurse take?

• A. Measure the client’s gastric residual every 12 hr.
• B. Obtain the client’s electrolyte levels every 4 hr.
• C. Keep the client’s head elevated at 15* during feedings.
• D. Flush the client’s tube with 30 mL of water every 4 hr.

Correct answer: D

Rationale: Flushing the client's tube with 30 mL of water every 4 hours helps maintain tube patency and prevent blockages.

5. A nurse is providing teaching to an obese client who has gestational diabetes and is at 25 weeks of gestation. Which of the following statements made by the client indicates a need for further teaching?

• A. This does not mean that my baby will have this disease.
• B. This means that I will have diabetes for the rest of my life.
• C. If I feel dizzy, I should drink six ounces of a non-diet soda.
• D. Being obese might be one reason why I developed diabetes.

Correct answer: B

Rationale: The belief that gestational diabetes results in lifelong diabetes is incorrect; it often resolves after pregnancy, though it does indicate a higher risk for developing type 2 diabetes in the future.

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