Nursing Elites

1. A client is being taught about dietary management of hypercholesterolemia. Which of the following foods should be suggested to add to the diet?

• A. Avocados
• B. Fried chicken
• C. Whole milk
• D. Bacon

Correct answer: A

Rationale: Avocados are a good choice to suggest adding to the diet of a client with hypercholesterolemia because they are high in healthy fats, particularly monounsaturated fats, which can help manage cholesterol levels. On the other hand, fried chicken, whole milk, and bacon are high in saturated fats and cholesterol, which should be limited in a diet aimed at managing hypercholesterolemia. Therefore, choices B, C, and D are incorrect.

2. In an emergency situation, the charge nurse on the night shift at an urgent care center has to deal with admitting clients of higher acuity than usual due to a large fire in the area. Which style of leadership and decision-making would be best in this circumstance?

• A. Assume a decision-making role
• B. Seek input from staff
• C. Use a non-directive approach
• D. Shared decision-making with others

Correct answer: A

Rationale: In an emergency situation such as dealing with patients of higher acuity due to a large fire, it is crucial for the charge nurse to assume a decision-making role. This style of leadership allows for quick and efficient decision-making to manage the increased acuity of patients effectively. Seeking input from staff (Choice B) may delay critical decisions needed in emergencies. Using a non-directive approach (Choice C) or shared decision-making with others (Choice D) may not be suitable in urgent situations where immediate actions are required to address the high acuity of patients.

3. A client receiving chlorpromazine HCL (Thorazine) is in psychiatric home care. During a home visit, the nurse observes the client smacking her lips alternately with grinding her teeth. The nurse recognizes this assessment finding as what?

• A. Dystonia
• B. Akathisia
• C. Bradykinesia
• D. Tardive dyskinesia

Correct answer: D

Rationale: The correct answer is D: Tardive dyskinesia. Tardive dyskinesia is a potential side effect of long-term antipsychotic use, characterized by involuntary movements like lip smacking and repetitive, purposeless movements. Choice A, dystonia, presents with sustained or repetitive muscle contractions. Choice B, akathisia, involves motor restlessness and a compelling need to be in constant motion. Choice C, bradykinesia, refers to slowness of movement typically seen in Parkinson's disease, not lip smacking and teeth grinding, which are indicative of tardive dyskinesia.

4. The nurse is preparing to administer digoxin (Lanoxin) to a client with heart failure. Which assessment finding would prompt the nurse to withhold the medication and contact the healthcare provider?

• A. Heart rate of 55 beats per minute
• B. Blood pressure of 140/90 mmHg
• C. Respiratory rate of 20 breaths per minute
• D. Blood glucose level of 150 mg/dL

Correct answer: A

Rationale: A heart rate below 60 beats per minute is a contraindication for administering digoxin, as it can lead to bradycardia. Bradycardia is a common adverse effect associated with digoxin toxicity. Blood pressure of 140/90 mmHg, respiratory rate of 20 breaths per minute, and blood glucose level of 150 mg/dL are within normal limits and would not warrant withholding the medication or contacting the healthcare provider in this context. Therefore, a heart rate of 55 beats per minute would prompt the nurse to withhold digoxin and notify the healthcare provider.

5. A healthcare professional uses a head-to-toe approach to conduct a physical assessment of a client who will undergo surgery the following week. Which of the following critical thinking did the healthcare professional demonstrate?

• A. Confidence
• B. Perseverance
• C. Integrity
• D. Discipline

Correct answer: D

Rationale: The correct answer is 'Discipline.' In this scenario, discipline is exemplified by following a structured and comprehensive assessment process, as seen in the head-to-toe approach. Confidence (choice A) relates to self-assurance and belief in one's abilities, which is not the primary critical thinking demonstrated in this situation. Perseverance (choice B) is the persistence in achieving goals despite challenges, not directly related to the systematic assessment process. Integrity (choice C) pertains to honesty and ethical behavior, which are important traits but not the critical thinking skill exemplified by the structured assessment process shown in the head-to-toe approach.

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