Nursing Elites

1. 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.

2. What is the primary food safety concern for a patient undergoing chemotherapy?

• A. Possible food allergy reactions
• B. Possible food-drug interactions
• C. Possible pesticide residue
• D. Potential risk of foodborne illness

Correct answer: D

Rationale: The correct answer is D: Potential risk of foodborne illness. Patients undergoing chemotherapy have compromised immune systems, making them more susceptible to foodborne illnesses. Chemotherapy can reduce the count of white blood cells, which impairs the body's ability to fight off infections from bacteria or other pathogens that might be present in food. Therefore, the prevention of foodborne illnesses is a critical concern for these patients. Choices A, B, and C, while they represent valid concerns for food safety in general, are not the primary concern for patients undergoing chemotherapy. These patients are at a heightened risk of experiencing severe complications from foodborne illnesses, making it a more significant concern than potential food allergies, food-drug interactions, or pesticide residues.

3. What intervention would be most appropriate for a patient who has difficulty eating because of chewing problems?

• A. Use squeeze bottles to pour liquids into the mouth
• B. Provide utensils that have modified handles
• C. Offer plates with food guards
• D. Provide soft foods

Correct answer: D

Rationale: Providing soft foods is crucial for patients with chewing difficulties to ensure they can consume adequate nutrition without discomfort.

4. Who most often prescribes a patient's diet order?

• A. Registered Nurse
• B. Physician
• C. Registered Dietetic Technician
• D. Occupational Therapist

Correct answer: B

Rationale: A patient's dietary order is most frequently prescribed by a physician. This is because the physician has a comprehensive understanding of the patient's medical condition and can thus determine the most suitable dietary plan. Registered dietitians often collaborate with physicians in this process, but the final prescription is made by the physician. Although registered nurses, dietetic technicians, and occupational therapists play significant roles in patient care, they typically do not prescribe diet orders.

5. A nurse that is always ready to answer for all his actions and decision is said to be:

• A. Accountable C. Critical thinker
• B. Responsible D. Assertive
• C.
• D.

Correct answer: A

Rationale: Patient safety and efficacy of care depend on actions rooted in established nursing protocols that consider both the immediate and long-term needs of the patient.

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