Nursing Elites

1. A client with iron deficiency anemia is being taught about dietary recommendations by a nurse. Which of the following dietary recommendations should the nurse include as a food that enhances iron absorption when consumed with nonheme iron?

• A. Tomato juice
• B. Tea
• C. Milk
• D. Dried Beans

Correct answer: Tomato juice

Rationale: Tomato juice is the correct answer because it contains vitamin C, which enhances the absorption of nonheme iron. Vitamin C helps convert nonheme iron into a form that is easier for the body to absorb. Tea and milk should be avoided when consuming nonheme iron as they can inhibit iron absorption. Dried beans, although a good source of iron, do not enhance iron absorption when consumed with nonheme iron.

2. What nursing diagnosis would be most appropriate for a patient with heart failure?

• A. risk for infection
• B. fluid volume excess
• C. impaired body temperature
• D. ineffective airway clearance

Correct answer: B

Rationale: The most appropriate nursing diagnosis for a patient with heart failure is 'fluid volume excess.' In heart failure, the heart's reduced pumping ability leads to fluid retention, causing an excess of fluid in the body. This can result in symptoms such as edema, shortness of breath, and weight gain. 'Risk for infection,' 'impaired body temperature,' and 'ineffective airway clearance' are not the most appropriate nursing diagnoses for a patient with heart failure as they do not directly relate to the pathophysiology and common issues seen in heart failure patients.

3. What is the term for a condition where one or more members of a household, including children, consistently have little or no food due to lack of money?

• A. Marginal Food Security
• B. Food Desert
• C. Very Low Food Security
• D. Food Insecurity

Correct answer: D: Food Insecurity

Rationale: The correct answer is 'D: Food Insecurity'. This term specifically describes a situation where household members consistently have inadequate access to food due to financial constraints. 'Marginal Food Security' (Choice A) refers to a situation where the quality or variety of food is reduced, but there is no significant decrease in food intake. A 'Food Desert' (Choice B) is an area with limited access to affordable and nutritious food. 'Very Low Food Security' (Choice C) is a term used to describe a severe level of food insecurity where eating patterns of household members are disrupted and food intake is reduced.

4. Where should a nurse auscultate the apex beat?

• A. At the fifth intercostal space, along the midclavicular line
• B. At the mid-sternum
• C. 2 inches to the left of the lower end of the sternum
• D. 1 inch to the left of the xiphoid process

Correct answer: A

Rationale: The correct location to auscultate the apex beat is at the fifth intercostal space, along the midclavicular line. This is where the apical impulse, also known as the point of maximal impulse (PMI), can be best heard. Choices B, C, and D are incorrect anatomical locations for auscultating the apex beat, which makes them incorrect choices. Auscultating at the correct location allows healthcare providers to assess the heart's function and detect any abnormalities in heart sounds, which is crucial for comprehensive patient care.

5. A paranoid client refuses to eat telling you that you poisoned his food. The best intervention to this client is:

• A. Taste the food in front of him and tell him that the food is not poisoned
• B. Offer other types of food until the client eats
• C. Simply state that the food is not poisoned
• D. Offer sealed foods

Correct answer: C

Rationale: Effective nursing care involves comprehensive assessments that address all aspects of a patient's condition, ensuring that interventions are appropriately targeted and outcomes are optimized.

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