Nursing Elites

1. The nurse is caring for a client taking warfarin. Which meal brought in by the client's family is a priority to remove before the client eats it?

• A. Oriental cabbage salad with chicken
• B. Beef enchilada, rice, and beans
• C. Ham and cheese sandwich
• D. Macaroni salad and grapefruit slices

Correct answer: C

Rationale: The correct answer is C. Ham is high in vitamin K, which can interfere with warfarin. Vitamin K can decrease the effectiveness of warfarin, an anticoagulant medication. Choices A, B, and D do not contain high levels of vitamin K and are less likely to interfere with the client's warfarin therapy.

2. Macronutrients include each of the following except one. Which one is the exception?

• A. Fat
• B. Polyunsaturated fatty acids
• C. Carbohydrate
• D. Protein

Correct answer: D

Rationale: Macronutrients are nutrients required by the body in large amounts to provide energy and include carbohydrates, fats, and proteins. While protein is essential for the body, it is not classified as a macronutrient. Proteins are made up of amino acids and serve various functions in the body, such as building and repairing tissues, but they are not a direct energy source like carbohydrates and fats. Therefore, protein is the exception among the listed options, making it the correct answer. Choice A, Fat, Choice B, Polyunsaturated fatty acids, and Choice C, Carbohydrate, are all examples of macronutrients that provide energy and support various bodily functions.

3. Which enzyme initiates protein digestion in the stomach?

• A. Pepsin
• B. Salivary Amylase
• C. CCK
• D. Secretin

Correct answer: A

Rationale: Pepsin is the enzyme that initiates protein digestion in the stomach. It breaks down proteins into smaller peptides, aiding in their further digestion and absorption in the intestines. Salivary Amylase (Choice B) functions in breaking down dietary carbohydrates in the mouth, not proteins. CCK (Choice C) and Secretin (Choice D) are hormones involved in the digestion of fats and carbohydrates, not proteins. Therefore, Choices B, C, and D are incorrect in the context of protein digestion in the stomach.

4. What describes a common physical change of aging that can affect an older adult's nutrition?

• A. reduced salivary output
• B. increased gastrointestinal motility
• C. abnormal cortisol production
• D. increase in number of taste buds

Correct answer: A

Rationale: Reduced salivary output is a common physical change in aging. This can affect an older adult's nutrition by impacting chewing, swallowing, and taste perception. The decrease in saliva production can make it harder to chew and swallow food effectively, affecting the overall eating experience. Additionally, saliva plays a role in taste perception, so a reduction in salivary output can lead to alterations in how food tastes, potentially impacting an individual's appetite and food choices. Increased gastrointestinal motility (choice B) is not typically associated with aging and would not directly affect nutrition. Abnormal cortisol production (choice C) is related to hormonal changes and is not a common physical change of aging that affects nutrition. An increase in the number of taste buds (choice D) is not a typical change associated with aging and would not have a significant impact on an older adult's nutrition.

5. Overdosage of medication or anesthetic can happen even with the aid of technology like infusion pumps, sphygmomanometer, and similar devices/machines. As a staff member, how can you improve the safety of using infusion pumps?

• A. Check the functionality of the pump before use
• B. Select the brand of infusion pump carefully
• C. Allow the technician to set the infusion pump before use
• D. Verify the flow rate against your calculation

Correct answer: D

Rationale: To enhance the safety of using infusion pumps, it is crucial to verify the flow rate against your calculation. This step ensures that the prescribed dosage is being delivered accurately, reducing the risk of medication errors. Checking the functionality of the pump before use (Choice A) is also important to ensure it is working properly. Allowing the technician to set the pump (Choice C) may not always guarantee the correct settings. Selecting the brand of infusion pump carefully (Choice B) is not directly related to the safe use of the pump.

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