Nursing Elites

1. A nurse is providing dietary teaching to a client who has a new diagnosis of irritable bowel syndrome. Which of the following recommendations should the nurse include?

• A. Consume food high in bran fiber.
• B. Increase intake of milk products.
• C. Sweeten foods with fructose corn syrup.
• D. Increase foods high in gluten.

Correct answer: A

Rationale: The correct recommendation for a client with irritable bowel syndrome is to consume food high in bran fiber. Bran fiber promotes regularity and can help reduce symptoms of IBS. Choices B, C, and D are incorrect because increasing milk products, sweetening foods with fructose corn syrup, and consuming foods high in gluten can exacerbate symptoms of irritable bowel syndrome in some individuals.

2. A nurse is planning care for a client who has chronic obstructive pulmonary disease (COPD). Which of the following interventions should the nurse include in the plan of care?

• A. Encourage the client to breathe deeply and cough every 4 hours.
• B. Provide a diet that is high in carbohydrates and low in protein.
• C. Teach the client pursed-lip breathing technique.
• D. Restrict the client's fluid intake to 1,500 mL per day.

Correct answer: C

Rationale: The correct answer is C: Teach the client pursed-lip breathing technique. Pursed-lip breathing helps clients with COPD improve oxygenation and reduce shortness of breath. Choice A is incorrect because deep breathing and coughing are not recommended every 4 hours for clients with COPD. Choice B is incorrect because a diet high in carbohydrates and low in protein is not specifically indicated for COPD. Choice D is incorrect because fluid restriction is not a standard intervention for COPD unless the client has comorbid conditions that necessitate it.

3. A client is receiving discharge teaching for a new prescription of metformin. Which of the following client statements demonstrates an understanding of the teaching?

• A. I will take this medication with my meals.
• B. I will take this medication at the same time every day.
• C. I will avoid drinking alcohol while taking this medication.
• D. I will expect to experience weight gain while taking this medication.

Correct answer: C

Rationale: The correct answer is C because clients taking metformin should avoid alcohol as it increases the risk of lactic acidosis. Choices A, B, and D are incorrect. Choice A is not specific to metformin but rather a general recommendation for some medications. Choice B is a good practice for medication adherence but does not relate specifically to metformin. Choice D is inaccurate as weight gain is not an expected side effect of metformin.

4. A nurse is reviewing the laboratory results of a client who is at 28 weeks of gestation. Which of the following laboratory values should the nurse report to the provider?

• A. Hgb 10 g/dL
• B. Platelets 300,000/mm³
• C. WBC count 12,000/mm³
• D. BUN 18 mg/dL

Correct answer: A

Rationale: The correct answer is A: Hgb 10 g/dL. A hemoglobin level of 10 g/dL is below the normal range for a pregnant client, indicating possible anemia, which is crucial to report during pregnancy to prevent complications for both the mother and the baby. Platelets, WBC count, and BUN levels within the listed values are generally within normal ranges for a pregnant individual at 28 weeks of gestation. Platelets play a role in blood clotting, WBC count helps in fighting infections, and BUN measures kidney function, all of which are typically expected to be within normal limits during pregnancy.

5. A nurse is caring for a client who has a new prescription for warfarin. Which of the following laboratory tests should the nurse use to monitor the client's therapeutic response to the medication?

• A. INR
• B. aPTT
• C. Platelet count
• D. Hemoglobin A1C

Correct answer: A

Rationale: The correct answer is A: INR. The INR (International Normalized Ratio) is the laboratory test used to monitor the therapeutic response of warfarin. It helps ensure that the client's clotting time is within the desired range to prevent complications such as excessive bleeding or clotting. Choice B, aPTT (Activated Partial Thromboplastin Time), is not typically used to monitor warfarin therapy but rather for assessing heparin therapy. Choice C, Platelet count, assesses the number of platelets in the blood and is not specifically used to monitor warfarin therapy. Choice D, Hemoglobin A1C, is a test used to monitor long-term blood sugar control in diabetic patients and is not relevant to monitoring warfarin therapy.

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