Nursing Elites

1. A nurse is reviewing the laboratory results for a client who has a history of atherosclerosis and notes elevated cholesterol levels. Which of the following statements by the client indicates the nurse should plan follow-up teaching on a low-cholesterol diet?

• A. "I flavor my meat with lemon juice."?
• B. "I eat two eggs for breakfast each morning."?
• C. "I cook my food with canola oil."?
• D. "I take an omega-3 supplement daily."?

Correct answer: B

Rationale: The correct answer is B. Eggs are high in cholesterol, so someone with elevated cholesterol levels, especially with a history of atherosclerosis, should be cautious about egg consumption. Choices A, C, and D are not as concerning for cholesterol levels. Lemon juice, canola oil, and omega-3 supplements do not significantly impact cholesterol levels compared to consuming eggs regularly.

2. A nurse is providing teaching to a group of parents of newborns who are planning to formula feed. Which of the following statements by a parent indicates a need for further teaching?

• A. "I will give formula to my baby at room temperature."
• B. "I will ensure my baby's feeds last 10 to 15 minutes."
• C. "I will burp my baby halfway through each feeding."
• D. "I will watch for signs my baby is full and stop the feeding."

Correct answer: B

Rationale: The correct answer is, "I will ensure my baby's feeds last 10 to 15 minutes." This statement indicates a need for further teaching because it suggests a strict time limit for feedings, which may not be appropriate for a newborn. Newborns should be allowed to feed as long as they want, typically around 20-30 minutes per breast if breastfeeding, or on-demand with formula. Choices A, C, and D demonstrate proper feeding practices such as feeding at room temperature, burping halfway through each feeding, and watching for signs of fullness to stop the feeding, which are all appropriate responses by a parent of a formula-fed newborn.

3. A client is being taught how to follow a low-purine diet for gout management. Which statement indicates the client understands the teaching?

• A. "I will need to limit the number of fruit servings each day."?
• B. "I should avoid eating liver and other organ meats."?
• C. "I can drink only white wine."?
• D. "I should choose red meat instead of poultry."?

Correct answer: B

Rationale: The correct answer is B. Organ meats like liver are high in purines, which can exacerbate gout symptoms. Choosing to avoid such foods is essential in following a low-purine diet. Option A is incorrect because fruits are generally low in purines and are not usually restricted in a low-purine diet. Option C is incorrect as white wine, just like other types of alcohol, should be consumed in moderation or avoided due to its purine content. Option D is incorrect because red meat, including beef and lamb, is high in purines and should be limited in a low-purine diet.

4. A multivitamin supplement containing folic acid is recommended for all young women because of the number of unintentional pregnancies in women 15 to 24 years old.

• A. Both the statement and the reason are correct and related
• B. Both the statement and the reason are correct but are not related
• C. The statement is correct, but the reason is not correct
• D. The statement is not correct, but the reason is correct

Correct answer: A

Rationale: Both the statement and the reason are correct and related. A multivitamin with folic acid is recommended for young women due to the high incidence of unplanned pregnancies in this age group.

5. For an incontinent elderly client who frequently wets his bed and develops redness and skin excoriation at the perianal area, what is the best nursing goal?

• A. Ensure that the bed linen is always dry
• B. Frequently check the bed for wetness and keep it dry
• C. Place a rubber sheet under the client's buttocks
• D. Keep the patient clean and dry

Correct answer: A

Rationale: The best nursing goal for an incontinent elderly client with skin excoriation is to ensure that the bed linen is always dry. This helps in preventing further skin breakdown and promoting skin integrity. Choice B, to frequently check the bed for wetness and keep it dry, may not address the issue of prevention if the linen is not consistently dry. Choice C, placing a rubber sheet under the client's buttocks, focuses more on protecting the mattress rather than addressing the client's skin condition directly. Choice D, keeping the patient clean and dry, is important but does not specifically address the preventive aspect of maintaining dry bed linen.

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