Nursing Elites

1. What is the most likely demonstration of cardiac cachexia?

• A. Decreased physical activity
• B. Weight loss and tissue wasting
• C. Poor urine output and tissue edema
• D. Cardiac arrhythmia and wet lung sounds

Correct answer: B

Rationale: Cardiac cachexia is a condition characterized by severe weight loss and tissue wasting. This typically occurs in patients suffering from heart failure due to an increased energy expenditure and reduced appetite, which is why choice B is the correct answer. The other choices are incorrect as they do not accurately describe the symptoms of cardiac cachexia. Decreased physical activity (choice A) can be a result of many conditions, not specifically cardiac cachexia. Poor urine output and tissue edema (choice C) are more indicative of kidney problems rather than cardiac cachexia. Finally, cardiac arrhythmia and wet lung sounds (choice D) are symptoms related to other cardiac conditions, not specifically to cardiac cachexia.

2. A client is being taught by a nurse about adding more fiber to the diet. Which of the following foods has the highest fiber content?

• A. 1 cup cooked sweet potato
• B. 1 slice rye toast
• C. 1 cup raw watermelon
• D. 1 oz cashews

Correct answer: D

Rationale: The correct answer is D, 1 oz of cashews. Cashews have a higher fiber content compared to sweet potato, rye toast, and watermelon. While sweet potatoes and rye toast contain fiber, cashews have a higher concentration, making them a better choice for increasing fiber intake. Watermelon, on the other hand, is low in fiber compared to the other options provided.

3. 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.

4. To ensure client safety before starting blood transfusions, the following are needed before the procedure can be done EXCEPT:

• A. take baseline vital signs
• B. warm the blood to room temperature for 30 minutes before administering the transfusion
• C. have two nurses verify client identification, blood type, unit number, and expiration date of blood
• D. get consent signed for blood transfusion

Correct answer: D

Rationale: To ensure client safety before starting blood transfusions, taking baseline vital signs, warming the blood to room temperature, and having two nurses verify client identification, blood type, unit number, and expiration date of blood are crucial steps. Consent for blood transfusion is required but is typically obtained before the procedure. The focus before the procedure should be on confirming the right client, blood product, and ensuring the blood is prepared correctly to minimize risks of transfusion reactions.

5. What is the digestive action of bile?

• A. It breaks down carbohydrates
• B. It breaks down proteins
• C. It breaks down lipids
• D. It aids in fat digestion

Correct answer: D

Rationale: Bile, which is produced by the liver and stored in the gallbladder, aids in the digestion of fats. It does this by emulsifying the fats, which makes them easier for the digestive enzymes, such as lipase, to break down. While choices A, B, and C could be seen as partially correct since fats are a type of lipid and the process of breaking down fats could be seen as breaking down lipids, the most accurate answer is D, as the primary function of bile is to aid in fat digestion, not the digestion of all types of lipids or the digestion of proteins or carbohydrates.

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