Nursing Elites

1. A nurse is reinforcing teaching with a client about dietary choices for celiac disease. Which of the following menu choices selected by the client indicates an understanding of the teaching?

• A. Hamburger on a wheat bun
• B. Baked chicken and potato chips
• C. Bacon, lettuce, and tomato sandwich on rye toast
• D. Beef and barley soup with crackers

Correct answer: B

Rationale: The correct answer is B because baked chicken and potato chips are gluten-free options suitable for a client with celiac disease. Choice A, a hamburger on a wheat bun, contains gluten, which is harmful to individuals with celiac disease. Choice C, a bacon, lettuce, and tomato sandwich on rye toast, also contains gluten. Choice D, beef and barley soup with crackers, includes gluten from the barley and crackers, making it unsuitable for someone with celiac disease.

2. A client is receiving treatment for hypothyroidism. Which of these assessments would be most concerning to the nurse?

• A. Heart rate of 70 beats per minute
• B. Blood pressure of 110/70 mm Hg
• C. Respiratory rate of 16 breaths per minute
• D. Temperature of 98.6 degrees Fahrenheit

Correct answer: B

Rationale: A blood pressure of 110/70 mm Hg would be most concerning to the nurse because changes in blood pressure can indicate worsening hypothyroidism, potentially leading to complications such as myxedema coma. A heart rate of 70 beats per minute, a respiratory rate of 16 breaths per minute, and a temperature of 98.6 degrees Fahrenheit are within normal ranges and not typically directly associated with hypothyroidism complications.

3. The nurse is instructing a 65-year-old female client diagnosed with osteoporosis. The most important instruction regarding exercise would be to

• A. Exercise by doing weight-bearing activities
• B. Exercise to reduce weight
• C. Avoid exercise activities that increase the risk of fracture
• D. Exercise to strengthen muscles and thereby protect bones

Correct answer: A

Rationale: The correct answer is A: Exercise by doing weight-bearing activities. Weight-bearing activities help strengthen bones and prevent further bone loss in clients with osteoporosis. This type of exercise includes activities like walking, dancing, and weightlifting, which help improve bone density. Choice B is incorrect because the primary focus should be on bone health, not weight reduction. Choice C is incorrect as avoiding all exercise activities that increase the risk of fracture can lead to muscle weakness and a decline in bone health. Choice D is also incorrect because while strengthening muscles is beneficial, the emphasis for osteoporosis management should be on weight-bearing exercises specifically.

4. A nurse is reinforcing teaching to transition from breastfeeding to whole milk with the parents of an infant. Which of the following months of age should the nurse recommend for transitioning the infant to whole milk?

• A. 6 months
• B. 8 months
• C. 10 months
• D. 12 months

Correct answer: D

Rationale: The correct answer is D: 12 months. Whole milk should be introduced at 12 months to ensure the infant's digestive system can handle the increased fat content. Introducing whole milk before 12 months can lead to digestive issues and potential allergies. Choices A, B, and C are incorrect because transitioning to whole milk before 12 months is not recommended for infants due to their digestive system still developing and not being able to handle the higher fat content of whole milk.

5. A client who is to have antineoplastic chemotherapy tells the nurses of a fear of being sick all the time and wishes to try acupuncture. Which of these beliefs stated by the client would be incorrect about acupuncture?

• A. Some needles go as deep as 3 inches, depending on where they're placed in the body and what the treatment is for. The needles are usually left in for 15 to 30 minutes.
• B. In traditional Chinese medicine, imbalances in the basic energetic flow of life — known as qi or chi — are thought to cause illness.
• C. The flow of life is believed to flow through major pathways in your body rather than nerve clusters.
• D. By inserting extremely fine needles into some of the over 400 acupuncture points in various combinations, it is believed that energy flow will rebalance to allow the body's natural healing mechanisms to take over.

Correct answer: C

Rationale: The belief stated in option C is incorrect about acupuncture. Acupuncture is based on the concept of qi flowing through major pathways in the body, known as meridians, rather than nerve clusters. This traditional Chinese medicine practice aims to balance the flow of qi to promote health and healing. Options A, B, and D are consistent with the principles of acupuncture and are not incorrect beliefs. Option A describes the depth and duration of needle placement, option B explains the role of imbalances in qi flow causing illness, and option D outlines how acupuncture helps rebalance energy flow for the body's natural healing mechanisms.

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