Nursing Elites

1. A nurse providing dietary teaching for a client who is at 29 weeks of gestation and has phenylketonuria. Which of the following suggested foods should the nurse include in the teaching?

• A. A peanut butter sandwich on wheat bread
• B. A sliced apple and red grapes
• C. A chocolate chip cookie with a glass of skim milk
• D. A scrambled egg with cheddar cheese

Correct answer: B

Rationale: The correct answer is B. Clients with phenylketonuria (PKU) must adhere to a strict low-phenylalanine diet to prevent neurological damage. Foods high in phenylalanine such as peanut butter, wheat bread, chocolate chip cookies, milk, scrambled eggs, and cheddar cheese should be avoided. Sliced apples and red grapes are low in phenylalanine, making them safe choices for individuals with PKU. Choice A (peanut butter sandwich on wheat bread), Choice C (chocolate chip cookie with a glass of skim milk), and Choice D (scrambled egg with cheddar cheese) are all high in phenylalanine and should be avoided by individuals with PKU.

2. Using Naegele's Rule, what is the estimated delivery date for a pregnant client whose last menstrual period was on May 4th, 2013?

• A. January 15, 2014
• B. February 11, 2014
• C. March 3, 2014
• D. December 25, 2013

Correct answer: B

Rationale: Naegele's rule is a standard method for calculating the estimated delivery date (EDD). It involves subtracting three months from the first day of the last menstrual period (LMP), adding seven days, and then adding one year. For a client with an LMP of May 4th, 2013, subtracting three months gives February 4th. Adding seven days results in a due date of February 11th, 2014, which is the correct answer. Choice A (January 15, 2014) is incorrect as it does not account for the full calculation. Choice C (March 3, 2014) is incorrect as it adds too many days in the calculation. Choice D (December 25, 2013) is incorrect as it does not follow the correct steps of Naegele's rule.

3. When designing a program for young adults regarding safe sexual practices, which strategy might reach the greatest number in the target group?

• A. Web-based applications
• B. Print-based media such as newspapers
• C. Television advertisements
• D. Brochures in kiosks in malls

Correct answer: A

Rationale: Web-based applications are the most effective strategy for reaching young adults in the target group regarding safe sexual practices. Young adults today are highly engaged with mobile technology and the internet, making web-based applications the most accessible and convenient method to disseminate information. Print-based media like newspapers may not have the same reach and engagement among young adults. Television advertisements might reach a broader audience, but they may not be as targeted to the specific demographic of young adults. Brochures in kiosks in malls are less likely to reach a large number of young adults compared to web-based applications, which can be accessed anytime and anywhere through mobile devices.

4. A nurse is assessing a client who is at 31 weeks of gestation. Which of the following findings should the nurse identify as an indication of a potential prenatal complication?

• A. Periodic tingling of fingers
• B. Absence of clonus
• C. Leg cramps
• D. Blurred vision

Correct answer: D

Rationale: Blurred vision can be an indicator of serious conditions such as preeclampsia, which involves hypertension and can lead to significant maternal and fetal complications. Periodic tingling of fingers, absence of clonus, and leg cramps are common discomforts during pregnancy but are not typically associated with serious prenatal complications like preeclampsia. Therefore, the correct answer is D.

5. A nurse is giving discharge instructions to a client who has a new ileostomy. The nurse should recognize that the teaching has been effective when the client states:

• A. I will make sure my medications are enteric-coated
• B. My stoma will drain liquid continuously
• C. I will change my pouch system every two weeks
• D. My stoma size will stay the same after it heals

Correct answer: B

Rationale: The correct answer is B. When a client with an ileostomy states that their stoma will drain liquid continuously, it indicates an understanding of the expected outcome. In an ileostomy, the stoma continuously drains liquid stool as it bypasses the large intestine where water is absorbed. Choices A, C, and D are incorrect because ensuring medications are enteric-coated, changing the pouch system every two weeks, and expecting the stoma size to remain the same after healing are not accurate statements related to an ileostomy.

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