Nursing Elites

1. A client is receiving chemotherapy and is being taught about preventing infection. Which of the following instructions should the nurse include?

• A. Take your temperature daily.
• B. Avoid fresh fruits and vegetables.
• C. Limit your intake of high-protein foods.
• D. Increase your intake of high-fat foods.

Correct answer: B

Rationale: Clients receiving chemotherapy are instructed to avoid fresh fruits and vegetables to lower the risk of infection. Fresh produce may harbor bacteria or other pathogens that could be harmful to individuals with compromised immune systems. Taking the temperature daily may be important but is not directly related to preventing infection. Limiting high-protein foods is not necessary unless there are specific dietary restrictions due to the treatment plan. Increasing the intake of high-fat foods is not recommended during chemotherapy as a high-fat diet may lead to other health issues.

2. A nurse is preparing to perform postmortem care for a client. Which of the following actions should the nurse take?

• A. Place the client's dentures in a labeled container
• B. Remove the client's IV lines
• C. Place the client's body in a semi-fowler's position
• D. Lower the client's head of the bed

Correct answer: B

Rationale: The correct action for the nurse to take when preparing to perform postmortem care is to remove the client's IV lines. This step is essential to help maintain the dignity and appearance of the body. Placing the client's dentures in a labeled container (Choice A) is not a priority during postmortem care as the focus is on the body's preparation. While positioning the body in a semi-fowler's position (Choice C) or lowering the client's head of the bed (Choice D) are common practices for living clients to prevent aspiration, they are not necessary after death. Therefore, the immediate action of removing IV lines is most appropriate in this situation.

3. A nurse is reviewing the medical history of a client who has angina. Which of the following findings in the client's medical history should the nurse identify as a risk factor for angina?

• A. Hyperlipidemia.
• B. COPD.
• C. Seizure disorder.
• D. Hyponatremia.

Correct answer: A

Rationale: The correct answer is A: Hyperlipidemia. Hyperlipidemia, which is an elevated level of lipids (fats) in the blood, is a well-established risk factor for angina. High levels of lipids can lead to atherosclerosis, a condition where fatty deposits build up in the arteries, reducing blood flow to the heart muscle and increasing the risk of angina. Choice B, COPD (Chronic Obstructive Pulmonary Disease), is not directly linked to an increased risk of angina. COPD primarily affects the lungs and is not a known risk factor for angina. Choice C, Seizure disorder, and Choice D, Hyponatremia (low sodium levels), are also not typically associated with an increased risk of angina. While medical conditions like hypertension, diabetes, and smoking are other common risk factors for angina, hyperlipidemia is specifically known for its impact on blood vessels, making it a key risk factor to identify in a client's medical history.

4. A nurse is caring for a client who is experiencing dysphagia. Which of the following interventions should the nurse implement?

• A. Administer thickened liquids.
• B. Provide small bites of food.
• C. Encourage the client to eat quickly to avoid fatigue.
• D. Have the client lie supine after meals.

Correct answer: A

Rationale: The correct intervention for a client with dysphagia is to administer thickened liquids. Thickened liquids help prevent aspiration, which is a common risk for clients with swallowing difficulties. Providing small bites of food (choice B) can help, but the priority is to modify the liquid consistency. Encouraging the client to eat quickly (choice C) is not recommended as it may increase the risk of aspiration and fatigue. Having the client lie supine after meals (choice D) can actually increase the risk of aspiration, especially in clients with dysphagia.

5. A healthcare professional is reviewing the laboratory results of a client who is receiving chemotherapy. Which of the following findings should the healthcare professional report immediately?

• A. White blood cell count of 4,500/mm³
• B. Hemoglobin level of 8 g/dL
• C. Platelet count of 90,000/mm³
• D. Serum potassium level of 3.5 mEq/L

Correct answer: C

Rationale: A platelet count of 90,000/mm³ indicates thrombocytopenia, which increases the risk of bleeding and requires immediate intervention. Thrombocytopenia can lead to serious bleeding complications, so it is crucial to address this finding promptly. A low white blood cell count (choice A) may indicate neutropenia but is not as immediately life-threatening as severe thrombocytopenia. A hemoglobin level of 8 g/dL (choice B) would require intervention but is not as urgent as addressing a critically low platelet count. A serum potassium level of 3.5 mEq/L (choice D) is on the lower side of normal but does not pose an immediate risk to the client's safety compared to severe thrombocytopenia.

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