Nursing Elites

1. A nurse is reviewing dietary assessment findings for a client who is Jewish and observes kosher dietary practices. Which of the following behaviors should the nurse expect to find?

• A. Leavened bread may be eaten during Passover
• B. Shellfish is commonly consumed in the diet
• C. Meat and dairy products are eaten separately
• D. Fasting from meat occurs during Hanukkah

Correct answer: C

Rationale: The correct answer is C. According to kosher dietary laws, meat and dairy products cannot be consumed together. This practice stems from the prohibition in Jewish law against cooking a young animal in its mother's milk. Therefore, the nurse should expect to find that meat and dairy products are eaten separately. Choices A, B, and D are incorrect. Leavened bread is not eaten during Passover (Choice A), shellfish is not consumed in the kosher diet (Choice B), and fasting from meat does not occur during Hanukkah (Choice D).

2. A nurse is assessing a client who was brought to the psychiatric emergency services by law enforcement. The client has disorganized, incoherent speech with loose associations and religious content. The nurse should recognize these signs and symptoms as consistent with which of the following?

• A. Alzheimer's disease
• B. Schizophrenia
• C. Substance intoxication
• D. Depression

Correct answer: B

Rationale: The correct answer is B: Schizophrenia. Disorganized speech, loose associations, and religious delusions are characteristic symptoms of schizophrenia. In this scenario, the client's presentation aligns with positive symptoms of schizophrenia, indicating a severe mental disorder requiring immediate attention. Choice A, Alzheimer's disease, primarily involves cognitive decline and memory impairment, not disorganized speech or religious content. Choice C, Substance intoxication, may present with altered mental status but typically lacks the persistent pattern of symptoms seen in schizophrenia. Choice D, Depression, is associated with a different set of symptoms such as low mood, anhedonia, and changes in appetite or sleep, rather than disorganized speech and loose associations.

3. A nurse is caring for a client who has breast cancer and has been receiving chemotherapy. Which of the following laboratory values should the nurse report to the provider?

• A. WBC 3,000/mm3
• B. Hemoglobin 14 g/dL
• C. Platelets 250,000/mm3
• D. aPTT 30 seconds

Correct answer: A

Rationale: A WBC count of 3,000/mm3 indicates neutropenia, a dangerous complication of chemotherapy that increases the risk of infection and requires immediate attention. Neutropenia is a common side effect of chemotherapy and can lead to life-threatening infections. Reporting a low WBC count is crucial to ensure timely intervention. Choices B, C, and D are within normal ranges and do not pose immediate risks to the client undergoing chemotherapy.

4. A client has a new prescription for metformin. Which of the following instructions should the nurse include in the teaching?

• A. Take the medication at bedtime
• B. Monitor your blood glucose level before each meal
• C. Stop taking the medication if you develop muscle pain
• D. You may experience diarrhea with this medication

Correct answer: D

Rationale: The correct answer is D: 'You may experience diarrhea with this medication.' Diarrhea is a common side effect of metformin, particularly when initiating the medication. It is important for clients to be aware of this potential side effect. Option A is incorrect because metformin is usually taken with meals to reduce gastrointestinal side effects. Option B is not directly related to metformin use. Option C is incorrect as muscle pain is not a common side effect of metformin and does not warrant stopping the medication.

5. A nurse is reviewing the laboratory results of a newborn who is 24 hours old. Which of the following findings should the nurse report to the provider?

• A. Hemoglobin 12 g/dL
• B. Glucose 50 mg/dL
• C. Bilirubin 4 mg/dL
• D. Platelets 200,000/mm³

Correct answer: C

Rationale: The correct answer is C: Bilirubin 4 mg/dL. A bilirubin level of 4 mg/dL is elevated for a newborn and requires monitoring and potential intervention to prevent complications such as jaundice and kernicterus. Elevated bilirubin levels in newborns can lead to serious neurological consequences. Choices A, B, and D are within normal ranges for a newborn and do not require immediate reporting to the provider. Therefore, the nurse should prioritize reporting the elevated bilirubin level to the provider for further evaluation and management.

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