Nursing Elites

1. A nurse is reinforcing teaching about food selection with a client who has a moderate burn injury. Which of the following foods should the nurse recommend as being high in vitamin C?

• A. Tomatoes
• B. Carrots
• C. Avocados
• D. Apricots

Correct answer: A

Rationale: Tomatoes are high in vitamin C, which is crucial for wound healing, making them an excellent recommendation for a client with a burn injury. Carrots, avocados, and apricots are not as rich in vitamin C compared to tomatoes, and therefore, they are not the best choice for promoting healing in this scenario.

2. A client with heart failure is receiving furosemide. Which of the following assessment findings indicates that the medication is effective?

• A. Elevated blood pressure.
• B. Absence of adventitious breath sounds.
• C. Weight gain of 1.4 kg (3 lb) in 24 hr.
• D. Decreased urine output.

Correct answer: B

Rationale: The absence of adventitious breath sounds indicates that furosemide is effective in managing heart failure. Adventitious breath sounds such as crackles indicate fluid accumulation in the lungs, a common complication of heart failure. Therefore, the absence of these abnormal sounds suggests that furosemide is effectively reducing fluid overload. Elevated blood pressure (choice A) is not a desired outcome in heart failure management. Weight gain (choice C) and decreased urine output (choice D) are signs of fluid retention and ineffective diuresis, indicating that furosemide is not working effectively.

3. A nurse is caring for a client who has an altered mental status and has become aggressive. Which of the following prescriptions should the nurse clarify with the provider prior to administration?

• A. Haloperidol
• B. Zolpidem
• C. Morphine
• D. Lorazepam

Correct answer: B

Rationale: The correct answer is B: Zolpidem. Zolpidem is a sedative-hypnotic medication that can worsen altered mental status, especially in clients who are already aggressive. Therefore, the nurse should clarify this prescription with the provider before administration to ensure it is safe for the client. Choice A, Haloperidol, is an antipsychotic commonly used to manage aggression in clients with altered mental status, making it an appropriate choice in this scenario. Choice C, Morphine, is an opioid analgesic and would not directly impact the client's altered mental status or aggression. Choice D, Lorazepam, is a benzodiazepine used to manage anxiety and agitation, which could be beneficial in this situation but does not have the same potential to exacerbate altered mental status as Zolpidem.

4. A nurse is caring for a 37-year-old woman with metastatic ovarian cancer admitted for nausea and vomiting. The physician orders total parenteral nutrition (TPN), a nutritional consult, and diet recall. Which of the following is the BEST indication that the patient's nutritional status has improved after 4 days?

• A. The patient eats most of the food served to her
• B. The patient has gained 1 pound since admission
• C. The patient's albumin level is 4.0mg/dL
• D. The patient's hemoglobin is 8.5g/dL

Correct answer: C

Rationale: An improved albumin level is the best indicator of improved nutritional status after TPN. Albumin is a key protein that reflects the body's overall nutritional status and is commonly used to assess nutritional health. Choices A, B, and D are not as reliable indicators of improved nutritional status. Choice A may not accurately reflect nutritional improvement as it could be influenced by factors other than nutrition. Choice B may indicate fluid retention or loss rather than true nutritional improvement. Choice D, hemoglobin level, is more related to anemia and oxygen-carrying capacity of the blood, rather than nutritional status.

5. What are the steps in managing a patient with a pressure ulcer?

• A. Clean the wound and apply a hydrocolloid dressing
• B. Debride necrotic tissue and apply antibiotics
• C. Apply an alginate dressing and elevate the affected area
• D. Use moisture-retentive dressings and reposition frequently

Correct answer: A

Rationale: The correct answer is A: Clean the wound and apply a hydrocolloid dressing. This step is crucial in managing a pressure ulcer as it helps protect the ulcer from infection and promotes healing by creating a moist environment conducive to tissue repair. Choice B, debriding necrotic tissue and applying antibiotics, is more suitable for managing infected pressure ulcers but not as the initial step. Choice C, applying an alginate dressing and elevating the affected area, may be part of the management but is not the initial step. Choice D, using moisture-retentive dressings and repositioning frequently, is important for prevention but not the first step in managing an existing pressure ulcer.

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