Nursing Elites

1. A nurse is providing discharge teaching for a client who has acute pancreatitis and has a prescription for fat-soluble vitamin supplements. The nurse should instruct the client to take a supplement for which of the following?

• A. Vitamin A
• B. Vitamin B1
• C. Vitamin C
• D. Vitamin B12

Correct answer: A

Rationale: In acute pancreatitis, malabsorption of fat-soluble vitamins can occur due to pancreatic enzyme insufficiency. Vitamin A is a fat-soluble vitamin that may need supplementation in this case. Vitamin B1 (thiamine), Vitamin C, and Vitamin B12 are water-soluble vitamins and are not typically affected by pancreatic enzyme insufficiency in acute pancreatitis. Therefore, the correct supplement for the client with acute pancreatitis is Vitamin A.

2. Can fluid retention cause lab values to be deceptively high, whereas dehydration may cause the values to be deceptively low?

• A. TRUE
• B. FALSE
• C. Not always
• D. Sometimes

Correct answer: B

Rationale: The statement is incorrect. Fluid retention generally results in lab values appearing deceptively low, not high, because the excess fluid dilutes the concentration of substances in the blood. Conversely, dehydration can make lab values appear deceptively high as the reduced fluid volume in the body means substances in the blood are less diluted. Choices 'C: Not always' and 'D: Sometimes' are not specific and do not directly address the statement in the question, hence they are incorrect.

3. Which of the following terms refers to a process by which an individual receives education about the recognition of stress reactions and management strategies for handling stress, which may be instituted after a disaster?

• A. Critical incident stress management
• B. Follow-up
• C. Debriefing
• D. Defusion

Correct answer: A

Rationale: Critical incident stress management is a process that provides individuals with education about recognizing stress reactions and strategizing management techniques for handling stress after a disaster. Choice B, 'Follow-up', is incorrect because it generally refers to continuing care after initial treatment, not specifically to stress management education. Choice C, 'Debriefing', is a process where individuals involved in a critical event are brought together to discuss the event and their reactions to it. It can be part of the critical incident stress management process, but it doesn't cover the whole process. Choice D, 'Defusion', is a technique used in the immediate aftermath of a traumatic event to help individuals process their experiences, but it does not encompass the full range of education about stress recognition and management strategies.

4. A client receiving continuous enteral tube feeding reports cramping and abdominal distention. Which of the following actions should the nurse take?

• A. Check for gastric residual.
• B. Apply low intermittent suction.
• C. Increase the rate of the feeding.
• D. Request a higher-fat formula.

Correct answer: A

Rationale: When a client on continuous enteral tube feeding experiences cramping and abdominal distention, the nurse should check for gastric residual. This assessment helps determine if the client is tolerating the feeding well or if there is a potential issue such as feeding intolerance. Applying low intermittent suction, increasing the feeding rate, or requesting a higher-fat formula are not appropriate actions for addressing the reported symptoms and may exacerbate the client's discomfort or lead to further complications.

5. Reducing the amount of trans fat in the diet is an effective method of decreasing the risk of CHD. Which food is most likely a source of trans fat?

• A. hot dogs
• B. whole milk
• C. fatty fish
• D. potato chips

Correct answer: D

Rationale: The correct answer is D: potato chips. Potato chips, especially when fried in hydrogenated oils, are a common source of trans fats, which are linked to an increased risk of coronary heart disease (CHD). Hot dogs (choice A) can also contain trans fats if made with processed meats and added fats. Whole milk (choice B) and fatty fish (choice C) do not typically contain trans fats, making them less likely sources compared to potato chips.

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