Nursing Elites

1. A paranoid client refuses to eat telling you that you poisoned his food. The best intervention to this client is:

• A. Taste the food in front of him and tell him that the food is not poisoned
• B. Offer other types of food until the client eats
• C. Simply state that the food is not poisoned
• D. Offer sealed foods

Correct answer: C

Rationale: Effective nursing care involves comprehensive assessments that address all aspects of a patient's condition, ensuring that interventions are appropriately targeted and outcomes are optimized.

2. Loss of smell results in a condition that limits the capacity to detect the flavor of food and beverages, called:

• A. hypergeusia
• B. dysgeusia
• C. anosmia
• D. phantom taste

Correct answer: C

Rationale: The correct answer is C: anosmia. Anosmia refers to the loss of smell, which significantly affects the ability to detect flavors. Hypergeusia and dysgeusia, choices A and B, refer to heightened or distorted taste, respectively. 'Phantom taste' in choice D is not the correct term for the condition described in the question.

3. A nurse is initiating continuous enteral feedings for a client who has a new gastrostomy tube. Which of the following actions should the nurse take?

• A. Measure the client’s gastric residual every 12 hours.
• B. Obtain the client’s electrolyte levels every 4 hours.
• C. Keep the client’s head elevated at 15° during feedings.
• D. Flush the client’s tube with 30 mL of water every 4 hours.

Correct answer: D

Rationale: Flushing the client’s tube with 30 mL of water every 4 hours is essential to maintain tube patency and prevent blockages. This action helps ensure the continuous flow of enteral feedings without obstruction. Measuring the client’s gastric residual every 12 hours (Choice A) is important but not the priority when initiating enteral feedings. Obtaining the client’s electrolyte levels every 4 hours (Choice B) is unnecessary and not directly related to tube feeding initiation. Keeping the client’s head elevated at 15° during feedings (Choice C) is a good practice to prevent aspiration, but tube flushing is more crucial to prevent tube occlusion.

4. The nurse is completing a nutritional assessment on a client. Which statement made by the client is most concerning to the nurse?

• A. "I notice when I take a vitamin E supplement, I bruise more easily."
• B. "I work nights and rarely go outside during the day."
• C. "I take warfarin, so I need to limit the amount of green leafy vegetables I eat."
• D. "My vitamin supplement has the recommended daily allowance of vitamin A."

Correct answer: A

Rationale: The correct answer is A. Excessive intake of vitamin E can increase the risk of bleeding as it acts as a blood thinner. Bruising easily may indicate too much vitamin E. Choice B is not as concerning as it describes a lifestyle that may lead to vitamin D deficiency due to lack of sunlight exposure. Choice C shows awareness of the interaction between warfarin and vitamin K, which is expected. Choice D indicates knowledge of the vitamin A content in the supplement, which is not a cause for concern.

5. Can a person with Celiac disease eat Poptarts that contain gluten?

• A. Yes
• B. No
• C. Only in small quantities
• D. Only if they are gluten-free Poptarts

Correct answer: B

Rationale: A person with Celiac disease cannot consume Poptarts that contain gluten because gluten is a protein found in wheat, barley, and rye, triggering an autoimmune response in individuals with Celiac disease and damaging their small intestine. Even small quantities of gluten can lead to this harmful response, making choices 'A' and 'C' incorrect. While gluten-free Poptarts may be suitable for individuals with Celiac disease, regular Poptarts containing gluten are not safe for consumption by them, rendering choice 'D' incorrect as well.

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