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 blood administration, what is essential for the nurse to do in order to carefully monitor for adverse reactions?

• A. Stay with the client for the first 15 minutes of blood administration
• B. Stay with the client for the entire period of blood administration
• C. Run the infusion at a faster rate during the first 15 minutes
• D. Inform the client to notify the staff immediately for any adverse reaction

Correct answer: A

Rationale: In the context of blood administration, it's crucial for the nurse to stay with the client for the first 15 minutes. This is because most adverse reactions are likely to occur within this initial period. Monitoring the client closely during this time allows for immediate detection and response to any potential reactions. Choice B, staying with the client for the entire period of blood administration, is not typically feasible or necessary, although regular checks should be conducted. Running the infusion at a faster rate during the first 15 minutes (Choice C) is incorrect as this can actually increase the risk of adverse reactions. Informing the client to notify the staff immediately for any adverse reaction (Choice D) is an important practice, but it is not the most direct way for the nurse to monitor for adverse reactions.

3. A nurse is teaching a client about strategies to prevent constipation. Which of the following statements by the client indicates an understanding of the teaching?

• A. Drinking four to five glasses of water per day will prevent constipation.
• B. I should consume mineral oil once per day.
• C. Eating foods high in fiber will make elimination easier.
• D. I can skip a meal if I feel bloated.

Correct answer: C

Rationale: The correct answer is C. Eating foods high in fiber increases stool bulk and promotes easier elimination, thus preventing constipation. Choices A, B, and D are incorrect. Drinking water is important, but the emphasis should be on high-fiber foods. Mineral oil is not a recommended first-line treatment for constipation, and skipping meals can disrupt regular bowel movements, potentially leading to constipation.

4. Mr. Bradley has been advised to limit his dairy product intake. What principle regarding fluid intake should be followed?

• A. Gelatin, soups, fruit ices, and frozen fruit bars contribute to your fluid intake
• B. Drink milk in moderation
• C. Increase fiber intake
• D. Limit protein intake

Correct answer: A

Rationale: For patients with kidney disease, it's important to manage fluid intake from all sources, including foods like gelatin and soups, which can contribute to fluid overload.

5. Which food items should be avoided by a child with lactose intolerance?

• A. Popcorn, seeds, and any foods containing nuts.
• B. Milk, cheese, ice cream, and puddings.
• C. Wheat, rye, barley, and commercially baked goods.
• D. Eggs, ham, bacon, and canned meats.

Correct answer: B

Rationale: The correct answer is B: Milk, cheese, ice cream, and puddings should be avoided by a child with lactose intolerance because they contain lactose, which the child's body may have difficulty digesting. Option A is incorrect as popcorn, seeds, and foods containing nuts do not typically contain lactose. Option C lists wheat, rye, barley, and commercially baked goods, which are sources of gluten, not lactose. Option D includes eggs, ham, bacon, and canned meats, which are also not sources of lactose. Therefore, B is the most appropriate choice for a child with lactose intolerance.

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