Nursing Elites

1. During blood administration, what is essential for the nurse to do in order to carefully monitor for adverse reactions?

• A. Stay with the client for the first 15 minutes of blood administration
• B. Stay with the client for the entire period of blood administration
• C. Run the infusion at a faster rate during the first 15 minutes
• D. Inform the client to notify the staff immediately for any adverse reaction

Correct answer: A

Rationale: In the context of blood administration, it's crucial for the nurse to stay with the client for the first 15 minutes. This is because most adverse reactions are likely to occur within this initial period. Monitoring the client closely during this time allows for immediate detection and response to any potential reactions. Choice B, staying with the client for the entire period of blood administration, is not typically feasible or necessary, although regular checks should be conducted. Running the infusion at a faster rate during the first 15 minutes (Choice C) is incorrect as this can actually increase the risk of adverse reactions. Informing the client to notify the staff immediately for any adverse reaction (Choice D) is an important practice, but it is not the most direct way for the nurse to monitor for adverse reactions.

2. A nurse is discussing denture care with the partner of a client who is unable to perform oral hygiene. Which of the following should be included in the discussion?

• A. Floss dentures as part of daily cleaning.
• B. Wipe dentures before storing them in a dry container at night.
• C. Wrap gloved fingers with gauze to remove dentures.
• D. Use a washcloth to clean the denture surfaces.

Correct answer: C

Rationale: The correct answer is C: 'Wrap gloved fingers with gauze to remove dentures.' This method provides a safe and effective way to remove dentures without causing damage. Choice A is incorrect because flossing dentures is not recommended. Choice B is incorrect as it suggests wiping dentures and storing them dry, which is not the best practice. Choice D is incorrect because using a washcloth may not effectively clean all denture surfaces.

3. Hypertrophic burn scars are caused by:

• A. exaggerated contraction
• B. random layering of collagen
• C. wound ischemia
• D. delayed epithelialization

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.

4. A patient is being discharged with a vitamin K deficiency. What food should the nurse recommend to the patient to include in their diet?

• A. Oranges
• B. Spinach
• C. Fish
• D. Nuts

Correct answer: B

Rationale: Spinach is an excellent source of vitamin K, which plays a vital role in blood clotting and bone health. Oranges, fish, and nuts do not contain significant amounts of vitamin K, making them less suitable choices to address a vitamin K deficiency. Therefore, the correct recommendation for a patient with a vitamin K deficiency would be to include spinach in their diet to help replenish this essential vitamin.

5. Which of the following statements are correct?

• A. Lipids are transported in the blood as lipoproteins, which are clusters of lipids associated with proteins.
• B. In type II diabetes, the pancreas produces insulin, but cells are resistant to this signal.
• C. The glycemic index classifies foods based on their potential to raise blood glucose levels.
• D. All of the above

Correct answer: D

Rationale: Option A is correct because lipoproteins indeed transport lipids in the blood. They are complexes of lipids and proteins that transport water-insoluble lipids through the blood. Option B is correct as it accurately describes the condition of type II diabetes where the pancreas can produce insulin, but the cells are resistant to its signal, causing an ineffective regulation of blood sugar. Option C is also correct because the glycemic index is indeed a classification system for foods based on their potential to raise blood glucose levels. High glycemic index foods raise blood glucose levels faster than low glycemic index foods. Hence, all the statements are correct, making option D the correct answer.

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