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. 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.

3. Mang David, A 27 year old psychiatric client was admitted with a diagnosis of schizophrenia. During the morning assessment, Mang David shouted “Did you know that I am the top salesman in the world? Different companies want me!” As a nurse, you know that this is an example of:

• A. Hallucination
• B. Delusion
• C. Confabulation
• D. Flight of Ideas

Correct answer: B

Rationale: Nursing interventions should be grounded in a deep understanding of the physiological processes involved, ensuring that care provided is both effective and efficient.

4. In some hip surgeries, an epidural catheter for Fentanyl epidural analgesia is given. What is your nursing priority care in such a case?

• A. Instruct the client to observe strict bed rest
• B. Check for epidural catheter drainage
• C. Administer analgesia through the epidural catheter as prescribed
• D. Assess respiratory rate carefully

Correct answer: D

Rationale: The nursing priority care in a case where an epidural catheter for Fentanyl epidural analgesia is given during hip surgeries is to assess the respiratory rate carefully. Respiratory depression is a potential side effect of Fentanyl, especially when administered epidurally. Monitoring the respiratory rate is crucial to detect any signs of respiratory distress promptly. Instructing the client to observe strict bed rest (Choice A) may be necessary but is not the priority over ensuring respiratory function. Checking for epidural catheter drainage (Choice B) and administering analgesia through the epidural catheter as prescribed (Choice C) are important aspects of care, but ensuring adequate ventilation takes precedence to prevent complications.

5. A client with anorexia undergoing radiation therapy is being taught by a nurse. Which instruction should the nurse include in the teaching?

• A. Limit high-calorie supplements to between meals
• B. Avoid overeating during your 'good' days
• C. Eat hot foods instead of cold foods
• D. Consume nutrient-dense foods first

Correct answer: D

Rationale: The correct instruction for a client with anorexia undergoing radiation therapy is to consume nutrient-dense foods first. This ensures that the client receives the necessary calories and nutrients. Option A is incorrect because high-calorie supplements should not be limited but rather incorporated wisely into the diet. Option B is incorrect as overeating is not recommended regardless of the type of day. Option C is incorrect as there is no specific preference for hot foods over cold foods in managing anorexia during radiation therapy.

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