Nursing Elites

1. Which meal should be removed for a client taking warfarin?

• A. Oriental cabbage salad with chicken
• B. Beef enchilada, rice, and beans
• C. Ham and cheese sandwich
• D. Macaroni salad and grapefruit slices

Correct answer: C

Rationale: The correct meal to remove for a client taking warfarin is the 'Ham and cheese sandwich.' Ham is high in vitamin K, which can interfere with the effectiveness of warfarin, a medication that works by decreasing the clotting ability of the blood. Vitamin K can counteract the effects of warfarin by promoting blood clotting. Choices A, B, and D do not contain high amounts of vitamin K and are therefore safer options for individuals taking warfarin.

2. 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.

3. Mang Carlos has a standing DNR order. He then suddenly stopped breathing and you are at his bedside. You would:

• A. Give extraordinary measures to save Mang Carlos
• B. Stay with Mang Carlos and Do nothing
• C. Call the physician
• D. Activate Code Blue

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. The following mechanisms can be utilized as part of the quality assurance program of your hospital EXCEPT:

• A. Patient satisfaction surveys
• B. Peer review to assess care provided
• C. Review of clinical records of care of client
• D. Use of Nursing Interventions Classification

Correct answer: C

Rationale: Effective nursing care involves comprehensive assessments that address all aspects of a patient's condition, ensuring that interventions are appropriately targeted and outcomes are optimized.

5. Which strategy would most likely help alleviate some of the nausea that a 10-week pregnant woman experiences every morning, preventing her from eating breakfast?

• A. Increase intake of dairy products, including yogurt and ice cream
• B. Maintain an upright position while eating
• C. Opt for foods that are high in fiber
• D. Consume small, frequent meals when hunger strikes

Correct answer: D

Rationale: The correct answer is D, 'Consume small, frequent meals when hunger strikes.' This strategy is ideal for managing morning sickness because it prevents the stomach from becoming too empty, which can exacerbate nausea. Option A may not be helpful because dairy products can sometimes worsen nausea. Option B is not the most effective solution as the sitting position does not directly impact nausea levels. Option C, while generally beneficial for digestion and overall health, does not specifically address the issue of pregnancy-related nausea.

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