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. What are the potential consequences of damage to the stomach?

• A. Reduced digestion of carbohydrates
• B. Inability to produce or secrete bile
• C. Inability to produce or secrete gastric acid
• D. Increased ability to produce or secrete intrinsic factor

Correct answer: C

Rationale: Damage to the stomach can lead to a reduced ability to produce gastric acid (Choice C) and intrinsic factor, the latter of which is crucial for vitamin B12 absorption (Choice D). That's why these two choices are correct. The stomach doesn't play a direct role in the digestion of carbohydrates (Choice A) as this process primarily occurs in the small intestine with the help of pancreatic enzymes. Similarly, bile is produced by the liver and stored in the gallbladder, not the stomach, hence stomach damage wouldn't lead to an inability to produce or secrete bile (Choice B).

3. What is a major feature of the therapeutic lifestyle changes (TLC) recommended for the treatment of high blood cholesterol?

• A. Avoiding all foods that contain cholesterol
• B. Reducing sodium intake to less than 2 g/day
• C. Limiting total fat intake to less than 30% of energy intake
• D. Limiting saturated fat intake to less than 7% of energy intake

Correct answer: D

Rationale: The correct answer is D, 'Limiting saturated fat intake to less than 7% of energy intake.' This is a central feature of the therapeutic lifestyle changes (TLC) recommended for treating high blood cholesterol. Saturated fats can increase low-density lipoprotein (LDL) cholesterol, a significant risk factor for heart disease. Choice A is incorrect because while it is recommended to limit cholesterol intake, it's not suggested to avoid all foods containing cholesterol entirely in the TLC. Choice B is also incorrect as although reducing sodium intake is beneficial for controlling blood pressure, it's not specifically targeted in the TLC for managing high cholesterol. Lastly, while limiting total fat intake is a healthy guideline, it's not as specific or effective as limiting saturated fat intake, making choice C also incorrect.

4. This study, which is an in-depth study of one boy, is a:

• A. case study
• B. longitudinal study
• C. cross-sectional study
• D. evaluative study

Correct answer: A

Rationale: The correct answer is 'A: case study.' A case study involves an in-depth examination of a single individual, group, or event. In this scenario, focusing on one boy aligns with the definition of a case study. The other options are not applicable: B) A longitudinal study involves following subjects over a period of time, C) A cross-sectional study examines a population at a single point in time, and D) An evaluative study assesses the effectiveness of a program or intervention, which is not the focus of the given scenario.

5. In the following ingredient list, which is the most abundant by weight? Ingredients: enriched flour, sugars, eggs, soy lecithin, artificial colors, natural flavors, milk.

• A. milk
• B. eggs
• C. sugar
• D. enriched flour

Correct answer: D

Rationale: The correct answer is 'enriched flour.' In ingredient lists, items are typically listed by weight in descending order. Therefore, the first ingredient, in this case, 'enriched flour,' is the most abundant by weight. Choice A, 'milk,' is not the most abundant as it appears last in the list. Choice B, 'eggs,' and choice C, 'sugar,' also rank lower in the list compared to 'enriched flour,' making them less abundant by weight.

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