Nursing Elites

1. The nurse is planning a meal plan that would provide the most iron for a child with anemia. Which dinner menu would be best?

• A. Fish sticks, french fries, banana, cookies, milk
• B. Ground beef patty, lima beans, wheat roll, raisins, milk
• C. Chicken nuggets, macaroni, peas, cantaloupe, milk
• D. Peanut butter and jelly sandwich, apple slices, milk

Correct answer: B

Rationale: The correct answer is B. Ground beef, lima beans, and raisins are rich sources of iron, making this meal plan the most suitable for a child with anemia. Ground beef is a high-iron meat, while lima beans and raisins are also excellent sources of iron. Fish sticks, french fries, banana, and cookies in option A lack sufficient iron content compared to the options in B. Chicken nuggets, macaroni, and peas in option C are not as iron-rich as the ground beef, lima beans, and raisins in option B. Peanut butter and jelly sandwich with apple slices in option D also fall short in providing enough iron when compared to the iron-rich components of option B.

2. When a nurse assigned to a manipulative client for 5 days becomes aware of feelings of reluctance to interact with the client, what should be the next action by the nurse?

• A. Discuss the feeling of reluctance with an objective peer or supervisor
• B. Limit contact with the client to avoid reinforcement of the manipulative behavior
• C. Confront the client about the negative effects of behaviors on other clients and staff
• D. Develop a behavior modification plan that will promote more functional behavior

Correct answer: A

Rationale: The correct action for the nurse in this situation is to discuss the feeling of reluctance with an objective peer or supervisor. By doing so, the nurse can address their emotions professionally and seek guidance on how to manage the situation effectively. This approach allows the nurse to receive support and potentially gain insights on how to navigate interactions with the manipulative client. Option B is incorrect because avoiding the client may not address the underlying issues causing the reluctance and can impact the quality of care provided. Option C is inappropriate as confronting the client directly about negative behaviors may escalate the situation and harm the therapeutic relationship. Option D is not the immediate action needed in this scenario; it is essential to address the nurse's feelings first before considering behavior modification plans.

3. A client newly diagnosed with type 1 diabetes mellitus is resistant to learning self-injection of insulin and asks the nurse to administer all the injections. The nurse explains the importance of learning self-care and appropriately adds which of the following statement?

• A. Insulin injections are not difficult to learn.
• B. Tell me what I can do to help you overcome your fear of giving yourself injections.
• C. It’s important to learn self-care for future independence.
• D. You need to learn this for your health.

Correct answer: B

Rationale: Choice B is the correct answer because it addresses the client's fear and offers support to help them overcome the resistance to self-care. By expressing willingness to assist and asking for ways to help the client, the nurse encourages open communication and collaboration in finding solutions to the client's concerns. Choices A, C, and D, while valid statements, do not directly address the client's fear or resistance, which is crucial in promoting self-care adherence in this situation.

4. The healthcare professional is preparing to administer an intramuscular injection to an adult client. Which site is most appropriate for the LPN/LVN to use?

• A. Deltoid muscle
• B. Ventrogluteal site
• C. Dorsogluteal site
• D. Rectus femoris site

Correct answer: B

Rationale: The ventrogluteal site is the most appropriate and safest site for administering an intramuscular injection to an adult client. It is preferred due to its thick muscle mass and fewer major blood vessels and nerves in the area, reducing the risk of injury or complications. The deltoid muscle is commonly used for vaccines and small-volume injections but may not be suitable for larger volumes. The dorsogluteal site has fallen out of favor due to the risk of injury to the sciatic nerve and other underlying structures. The rectus femoris site is not typically used for intramuscular injections in adults.

5. While observing a student nurse administering a narcotic analgesic IM injection without aspirating, what should the nurse do?

• A. Ask the student, 'What did you forget to do?'
• B. Stop and explain why aspiration is needed.
• C. Quietly state, 'You forgot to aspirate.'
• D. Walk up and whisper in the student's ear, 'Stop. Aspirate. Then inject.'

Correct answer: D

Rationale: When the nurse observes a student nurse making a mistake during a procedure, such as not aspirating before administering a medication, the nurse should provide immediate, discreet feedback to correct the error. Walking up and whispering in the student's ear to stop, aspirate, and then inject is appropriate as it corrects the mistake while maintaining the student's dignity and confidence. Option A is not as effective as it indirectly addresses the issue. Option B is not the best approach as the student needs immediate correction. Option C is not ideal as loudly stating the mistake may embarrass the student and is not necessary for a discreet correction.

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