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. Which of the following foods should be avoided by patients experiencing xerostomia, except one? Which is the exception?

• A. Saltines
• B. Salsa
• C. Alcohol
• D. Dill pickles

Correct answer: D

Rationale: The correct answer is Dill pickles. Unlike the other choices, which can exacerbate xerostomia due to their dry or irritating nature, dill pickles, being tart and sour, can actually help stimulate saliva flow, which is beneficial for patients with xerostomia. Saltines, salsa, and alcohol are all known to contribute to dry mouth and should generally be avoided by individuals experiencing xerostomia.

3. A healthcare professional is reviewing the laboratory findings of a client who has heart failure. Which of the following findings indicates that the client is experiencing fluid volume excess?

• A. BUN 8 mg/dL
• B. Hgb 15 g/dL
• C. Creatinine 0.8 mg/dL
• D. Sodium 140 mEq/L

Correct answer: A

Rationale: A BUN level of 8 mg/dL indicates fluid volume excess in a client with heart failure. BUN (Blood Urea Nitrogen) levels can be low in fluid overload due to hemodilution, a common occurrence in heart failure. High levels of BUN usually indicate dehydration or impaired renal function, which are not the case in fluid volume excess. Choices B, C, and D are within normal ranges and do not specifically indicate fluid volume excess.

4. Each statement is true of calcium within saliva, except one. Which is the exception?

• A. Saliva is supersaturated with calcium.
• B. Saliva is a source of calcium to mineralize an immature or demineralized enamel surface.
• C. Calcium and phosphate in saliva provide a buffering action.
• D. Calcium within saliva increases dental caries.

Correct answer: D

Rationale: The correct answer is D. Calcium within saliva does not increase dental caries; in fact, the buffering action provided by calcium and phosphate in saliva inhibits caries formation by preventing the dissolution of enamel by plaque biofilm. Choice A is correct as saliva is indeed supersaturated with calcium. Choice B is correct as saliva serves as a source of calcium to mineralize an immature or demineralized enamel surface. Choice C is correct as calcium and phosphate in saliva do provide a buffering action to protect teeth from acids.

5. Which nursing diagnosis has nutritional implications?

• A. impaired dentition
• B. disruption of gas exchange
• C. self-esteem disturbance
• D. sleep pattern disturbance

Correct answer: A

Rationale: Impaired dentition affects a patient's ability to chew and consume a variety of foods, leading to potential nutritional deficiencies and malnutrition.

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