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. During the phallic stage, with which parent must the child identify?

• A. The same-sex parent
• B. The opposite-sex parent
• C. The mother or the primary caregiver
• D. Both parents

Correct answer: A

Rationale: According to Freud's psychosexual development theory, during the phallic stage (approximately ages 3 to 6), the child starts to identify with the parent of the same sex. This identification is a crucial part of the child's development and is believed to influence their adult behavior. The process involves the child adopting the characteristics, attitudes, and values of the same-sex parent. Choice B, C, and D are incorrect as they do not align with Freud's theory of the phallic stage of psychosexual development.

3. A client who is in her second trimester of pregnancy should increase her caloric intake by how many calories during this trimester?

• A. 110 cal/day
• B. 225 cal/day
• C. 340 cal/day
• D. 450 cal/day

Correct answer: C

Rationale: During the second trimester of pregnancy, it is recommended that a client increases their caloric intake by around 340 calories per day to support the growing needs of both the mother and the developing fetus. This additional intake helps ensure the proper nutrition and energy levels required during this crucial stage of pregnancy. Option A (110 cal/day) is too low to meet the increased demands. Option B (225 cal/day) is also below the recommended amount. Option D (450 cal/day) is higher than necessary and could lead to excessive weight gain, which is not ideal during pregnancy.

4. Which student lunch is the least nutritious?

• A. Ham sandwich, apple, and milk
• B. Hamburger, fries, and soft drink
• C. Macaroni and cheese, green beans, and peaches
• D. Meatloaf, broccoli, and pear slices

Correct answer: B

Rationale: The correct answer is B - 'Hamburger, fries, and soft drink' as it contains foods high in unhealthy fats, sugars, and low nutritional value. A hamburger, fries, and a soft drink are considered less nutritious compared to the other options. Choice A includes a ham sandwich, apple, and milk, which provide a balance of protein, fiber, and calcium. Choice C consists of macaroni and cheese, green beans, and peaches, offering a mix of carbohydrates, vegetables, and fruits. Choice D contains meatloaf, broccoli, and pear slices, which provide a good source of protein, vitamins, and fiber. Therefore, option B is the least nutritious among the given choices.

5. What is the most likely complication for a client receiving TPN who suddenly develops tremors, dizziness, and diaphoresis?

• A. Fluid volume overload
• B. Sepsis
• C. Hyperglycemia
• D. Hypoglycemia

Correct answer: D

Rationale: The correct answer is D, Hypoglycemia. When a client receiving TPN suddenly develops tremors, dizziness, and diaphoresis, it is indicative of hypoglycemia. TPN provides a high concentration of glucose, and if it is abruptly stopped or the infusion rate is reduced, it can lead to hypoglycemia. Choices A, B, and C are incorrect as they do not directly correlate with the symptoms described in the scenario. Fluid volume overload typically presents with edema and hypertension, sepsis with fever and increased heart rate, and hyperglycemia with polyuria, polydipsia, and blurred vision.

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