Nursing Elites

1. The HCP gives a pregnant woman a prescription for one prenatal vitamin with iron daily and tells her that she needs to increase foods in her diet because her hemoglobin is 8.2 grams/dL. When a list of iron-rich foods is given to the client, she tells the PN that she is a vegetarian and does not eat anything that "bleeds." Which instruction should the PN provide?

• A. All below
• B. Increase green leafy vegetables in the diet
• C. Oatmeal is a good choice for breakfast
• D. Add lentils and black beans to soup

Correct answer: A

Rationale: Vegetarians can increase their iron intake through plant-based sources such as green leafy vegetables, oatmeal, and legumes, which are rich in iron.

2. Before administering an antibiotic that can cause nephrotoxicity, which lab value is most important for the PN to review?

• A. Hemoglobin and Hematocrit
• B. Serum Calcium
• C. Serum Creatinine
• D. WBC

Correct answer: C

Rationale: Serum creatinine is the most important lab value to review before administering an antibiotic that can cause nephrotoxicity. This is because serum creatinine is a key indicator of kidney function. An elevated serum creatinine level may indicate impaired renal function, and administering nephrotoxic drugs in such situations can further damage the kidneys. Monitoring serum creatinine levels helps healthcare providers assess renal function and make informed decisions regarding drug administration. Choices A, B, and D are not as directly related to kidney function and nephrotoxicity, making them less crucial in this scenario. Hemoglobin and hematocrit levels assess for anemia, serum calcium levels are more related to bone health and nerve function, and WBC count is associated with immune response, none of which directly reflect kidney function or the risk of nephrotoxicity.

3. A client is recovering from a right-sided mastectomy and is concerned about lymphedema. What should the nurse include in the discharge teaching to minimize this risk?

• A. Encourage wearing tight clothing on the affected arm.
• B. Advise against lifting heavy objects with the affected arm.
• C. Recommend the client sleep on the affected side.
• D. Suggest frequent massage of the affected arm.

Correct answer: B

Rationale: The correct answer is B: Advise against lifting heavy objects with the affected arm. Lifting heavy objects with the affected arm can increase the risk of lymphedema. It is important for clients to avoid activities that strain the affected arm to minimize the risk of developing lymphedema. Choices A, C, and D are incorrect because wearing tight clothing on the affected arm, sleeping on the affected side, and frequent massage of the affected arm can potentially worsen lymphedema or impede the recovery process. Tight clothing can impede lymphatic flow, sleeping on the affected side can restrict circulation, and frequent massage can exacerbate swelling in the arm.

4. A nurse is reviewing the basal body temperature method with a couple. Which of the following statements would indicate that the teaching has been successful?

• A. I don't need to buy a special type of thermometer.
• B. I need to wait 5 minutes after smoking a cigarette before I take my temperature.
• C. I need to take my temperature before I get out of bed in the morning.
• D. I need to take my temperature at least once every day.

Correct answer: C

Rationale: The correct answer is C. Basal body temperature must be taken before getting out of bed in the morning to get an accurate reading, as even slight activity can raise body temperature and affect the results. Choice A is incorrect because a special type of thermometer is not required for basal body temperature measurement. Choice B is incorrect because smoking can affect body temperature, but the timing mentioned is not relevant to basal body temperature measurement. Choice D is incorrect because while it is essential to take the temperature consistently each day, the duration of temperature measurement is not specified, making this choice less specific compared to the correct answer.

5. A child with glomerulonephritis is admitted in the acute edematous phase. Based on this diagnosis, which nursing intervention should the PN plan to include in the child's plan of care?

• A. Recommend parents bring favorite snacks
• B. Encourage ambulation daily to the playroom
• C. Measure blood pressure every 4 to 6 hours
• D. Offer a selection of fresh fruit for each meal

Correct answer: C

Rationale: The correct answer is to measure blood pressure every 4 to 6 hours. In glomerulonephritis, monitoring blood pressure is crucial as hypertension is a common complication. This helps in assessing the child's condition and response to treatment. Choice A, recommending parents bring favorite snacks, is not related to managing glomerulonephritis. Choice B, encouraging ambulation daily to the playroom, may not be appropriate during the acute edematous phase when the child may be experiencing fluid overload. Choice D, offering a selection of fresh fruit for each meal, is not directly relevant to managing the complications of glomerulonephritis.

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