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. A nurse is caring for a client with a major burn injury and is receiving TPN. Which of the following lab tests is the priority for the nurse to use to confirm the client is receiving adequate nutrition?

• A. Iron
• B. Magnesium
• C. Folic acid
• D. Prealbumin

Correct answer: D

Rationale: Prealbumin is a sensitive indicator of protein status and nutrition, making it a priority for assessing nutritional adequacy in clients receiving TPN. Iron, magnesium, and folic acid levels are important for overall health but do not specifically indicate nutritional adequacy in the context of TPN administration.

3. The term associated with loss of taste is:

• A. Xerostomia
• B. Hypogeusia
• C. Dysphagia
• D. Anosmia

Correct answer: B

Rationale: The correct answer is B, 'Hypogeusia.' Hypogeusia refers to a diminished sense of taste, which can impact nutritional intake, especially in older adults. Xerostomia (choice A) is dry mouth, Dysphagia (choice C) is difficulty swallowing, and Anosmia (choice D) is the loss of the sense of smell. These conditions are different from loss of taste, making them incorrect choices for this question.

4. A client who underwent surgical placement of a colostomy is being cared for by a nurse. Which of the following statements indicates the client understands the dietary teaching?

• A. "Eating yogurt can help decrease the amount of gas that I have."?
• B. "I should eliminate pasta from my diet so that I don't have as many loose stools."?
• C. "My largest meal of the day should be in the evening."?
• D. "Carbonated beverages can help control odor."?

Correct answer: D

Rationale: The correct answer is D. Carbonated beverages can help control odor in clients with colostomies. This is because carbonated drinks can help decrease odor by reducing the production of odoriferous compounds in the colon. Choices A, B, and C are incorrect. Eating yogurt may help regulate bowel movements but does not specifically address odor control associated with colostomies. Eliminating pasta from the diet to reduce loose stools is not necessary for colostomy care. The timing of the largest meal of the day is not directly related to dietary teaching for colostomy care.

5. You notice that Miss Kate, a bread vendor, receives and changes money, then holds the bread without washing her hands. As a nurse, what should you say to Miss Kate?

• A. Miss, don't touch the bread, I'll be the one to pick it up.
• B. Miss, please wash your hands before you pick up the bread.
• C. Miss, use a pick-up forceps when picking up the bread.
• D. Miss, your hands are dirty, I guess I'll try another bread shop.

Correct answer: B

Rationale: The correct answer is B, as it emphasizes the importance of hygiene in food handling, which is crucial to prevent the spread of germs and diseases. The other options do not address the root of the issue, which is the unhygienic handling of food. Option A avoids direct confrontation but does not educate the vendor on proper hygiene. Option C, although it suggests a hygienic method, may not be practical or available in all situations. Option D is an avoidance strategy rather than a way to address the problem.

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