Nursing Elites

1. A client receiving filgrastim (Neupogen) for neutropenia is learning about compromised host precautions. The selection of which lunch suggests the client has learned about necessary dietary changes?

• A. grilled chicken sandwich and skim milk
• B. roast beef, mashed potatoes, and green beans
• C. peanut butter sandwich, banana, and iced tea
• D. barbecue beef, baked beans, and cole slaw

Correct answer: B

Rationale: Roast beef, mashed potatoes, and green beans are suitable choices for clients with neutropenia because they are considered safe options that help avoid potential sources of infection. Grilled chicken, peanut butter, and barbecue beef may carry a higher risk of bacterial contamination, which could be harmful to a client with compromised immunity.

2. While caring for a client who was admitted with myocardial infarction (MI) 2 days ago, the nurse notes today's temperature is 101.1 degrees Fahrenheit (38.5 degrees Celsius). The appropriate nursing intervention is to

• A. Call the health care provider immediately
• B. Administer acetaminophen as ordered as this is normal at this time
• C. Send blood, urine, and sputum for culture
• D. Increase the client's fluid intake

Correct answer: B

Rationale: In this scenario, the nurse should administer acetaminophen as ordered because a slight fever is normal after an MI. This intervention can help manage the fever unless other complications are present. Calling the health care provider immediately is not necessary for a slight fever post-MI. Sending blood, urine, and sputum for culture is not indicated solely based on a slight fever without other symptoms or signs of infection. Increasing fluid intake may be beneficial for various reasons but is not the priority in this situation where managing the fever with acetaminophen is appropriate.

3. The nurse has been teaching a client with Insulin Dependent Diabetes Mellitus. Which statement by the client indicates a need for further teaching?

• A. I use a sliding scale to adjust regular insulin to my sugar level.
• B. Since my eyesight is so bad, I ask the nurse to fill several syringes.
• C. I keep my regular insulin bottle in the refrigerator.
• D. I always make sure to shake the NPH bottle hard to mix it well.

Correct answer: D

Rationale: Shaking the NPH insulin bottle hard can cause air bubbles and affect dosing accuracy; it should be rolled gently instead.

4. A client with a history of pancreatitis should avoid which of the following food choices?

• A. Noodles
• B. Vegetable soup
• C. Baked fish
• D. Cheddar cheese

Correct answer: D

Rationale: Clients with pancreatitis should avoid high-fat foods like cheddar cheese as they can exacerbate symptoms. Noodles, vegetable soup, and baked fish are generally lower in fat and may be better tolerated by clients with pancreatitis.

5. A client with a history of deep vein thrombosis (DVT) is being treated with anticoagulants. Which of these findings is most concerning to the nurse?

• A. Presence of bruising on the arms and legs
• B. The client reports new onset of severe headache
• C. The client reports pain and swelling in the calf
• D. The client reports increased urination

Correct answer: C

Rationale: The correct answer is C because pain and swelling in the calf can indicate a new or worsening DVT, requiring immediate attention. Bruising on the arms and legs may be a common side effect of anticoagulants but is not as concerning as a potential DVT. Severe headache may indicate other conditions like a migraine or hypertension and is not directly related to DVT. Increased urination is not typically associated with DVT and may point towards other health issues like diabetes or urinary tract infections.

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