Nursing Elites

1. A nurse is preparing a teaching plan for a client who has neutropenia as a result of radiation therapy for the treatment of lung cancer. Which of the following should the nurse plan to include in the teaching?

• A. Bottled water is an appropriate choice to increase fluid intake.
• B. The salad bar is a healthy choice when dining out.
• C. Soft-boiled eggs are an appropriate source of protein.
• D. Eating at a buffet is a good choice to increase caloric intake.

Correct answer: A

Rationale: In neutropenia, which is a low count of neutrophils, the client is at a high risk of infection. It is crucial to emphasize the importance of proper hydration to maintain overall health. Bottled water is a safe choice as it reduces the risk of exposure to contaminants that could further compromise the client's immune system. The other options, like the salad bar, soft-boiled eggs, and eating at a buffet, may not be suitable for a client with neutropenia due to the risk of bacterial contamination or exposure to pathogens that could lead to infections, which should be avoided.

2. What does oliguria lead to in patients with acute kidney injury?

• A. Hypophosphatemia and overgrowth of bone tissue
• B. An increase in blood potassium levels due to excessive excretion of parathyroid hormone
• C. Sodium retention and elevated levels of potassium
• D. Edema due to increased urine production

Correct answer: C

Rationale: In patients with acute kidney injury, oliguria (reduced urine output) often results in sodium retention and hyperkalemia (elevated levels of potassium). This is due to the kidneys' decreased capacity to excrete these substances. Choice A is incorrect because hypophosphatemia and overgrowth of bone tissue are not direct consequences of oliguria in acute kidney injury. Choice B is incorrect because an increase in blood potassium levels is not caused by excessive excretion of parathyroid hormone but rather by decreased excretion of potassium. Choice D is incorrect because edema is not caused by increased urine production but rather by fluid overload due to decreased urine output.

3. Why do older adult female clients need less iron than younger adult female clients?

• A. The need for iron decreases because older female clients produce more red blood cells.
• B. The need for iron decreases with age because older female clients carry oxygen more efficiently.
• C. The need for iron decreases with age because older female clients experience menopause.
• D. The need for iron decreases with age because older female clients exercise more.

Correct answer: C

Rationale: The correct answer is C. Older adult female clients need less iron than younger adult female clients because as women go through menopause, they no longer lose blood through menstruation, leading to a reduced need for iron. Choice A is incorrect because producing more red blood cells does not directly correlate with needing less iron. Choice B is incorrect as carrying oxygen more efficiently does not necessarily decrease the need for iron. Choice D is incorrect as exercising more does not explain the decreased need for iron in older adult female clients.

4. The oral cavity is the site of a wide variety of systemic disease manifestations due to:

• A. Rapid cellular turnover
• B. Constant attack by microorganisms
• C. Trauma-intense environment
• D. All of the above

Correct answer: D

Rationale: The oral cavity is indeed the site of various systemic disease manifestations due to multiple factors. Firstly, the rapid cellular turnover in the oral mucosa makes it susceptible to diseases. Secondly, the constant presence of microorganisms in the oral cavity contributes to the development of systemic diseases. Finally, the oral cavity being a trauma-intense environment further increases the risk of systemic manifestations. Therefore, all the provided options - rapid cellular turnover, constant attack by microorganisms, and a trauma-intense environment - play a role in making the oral cavity a site for various systemic diseases. Hence, the correct answer is 'All of the above.' Choices A, B, and C are incorrect individually as they each represent only one aspect of why the oral cavity is prone to systemic disease manifestations, whereas the correct answer encompasses all these factors.

5. What sensation is used as a gauge so that patients with ileostomy can determine how often their pouch should be drained?

• A. Sensation of taste
• B. Sensation of pressure
• C. Sensation of smell
• D. Urge to defecate

Correct answer: B

Rationale: The correct answer is B: Sensation of pressure. Patients with ileostomy can determine how often their pouch should be drained by feeling the sensation of pressure. This is important as it helps prevent leakage or overflow of the pouch. The sensation of taste (choice A) and smell (choice C) are not typically used as gauges for draining the pouch in ileostomy patients. The urge to defecate (choice D) is not relevant in this context as patients with ileostomy do not pass stool through the rectum.

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