Nursing Elites

1. Why do older adult female clients need less iron than younger adult female clients?

• A. The need for iron decreases because older female clients produce more red blood cells.
• B. The need for iron decreases with age because older female clients carry oxygen more efficiently.
• C. The need for iron decreases with age because older female clients experience menopause.
• D. The need for iron decreases with age because older female clients exercise more.

Correct answer: C

Rationale: The correct answer is C. Older adult female clients need less iron than younger adult female clients because as women go through menopause, they no longer lose blood through menstruation, leading to a reduced need for iron. Choice A is incorrect because producing more red blood cells does not directly correlate with needing less iron. Choice B is incorrect as carrying oxygen more efficiently does not necessarily decrease the need for iron. Choice D is incorrect as exercising more does not explain the decreased need for iron in older adult female clients.

2. A nurse is caring for four clients. The nurse should plan to administer total parenteral nutrition for which of the following clients?

• A. A client who is postoperative following a laminectomy and is receiving IV PCA
• B. A client who has dysphagia and does not recognize his family
• C. A client who has COPD and is going home with oxygen
• D. A client who has colon cancer and will undergo a hemicolectomy

Correct answer: D

Rationale: Total parenteral nutrition (TPN) is essential for clients undergoing significant surgical procedures like a hemicolectomy to ensure they receive adequate nutrition when oral intake is not possible. Choices A, B, and C do not typically require TPN. Choice A is managing postoperative pain with IV PCA, choice B is likely to need alternative feeding methods due to dysphagia, and choice C is going home with oxygen for COPD management, which does not directly relate to the need for TPN.

3. Which of the following actions would be of highest priority with regards to the external shunt?

• A. Avoid taking blood pressure or blood sample from the arm with the shunt
• B. Instruct the patient not to exercise the arm with the shunt
• C. Heparinize the shunt daily
• D. Change the dressing of the shunt daily

Correct answer: C

Rationale: Heparinizing the shunt daily (choice C) is the highest priority action as it prevents the formation of blood clots that can occlude the shunt, leading to potential complications such as thrombosis. Avoiding taking blood pressure or blood samples from the arm with the shunt (choice A) is also important, but secondary to heparinizing the shunt. Similarly, instructing the patient not to exercise the arm with the shunt (choice B) can help prevent unnecessary strain on the shunt, but it is not as critical as preventing clot formation. Changing the dressing of the shunt daily (choice D) is a standard nursing care practice to prevent infection, but again, it is not as critical as ensuring the shunt remains patent through daily heparinization.

4. Which of the following questions illustrates the group role of encourager?

• A. What were you saying?
• B. Who wants to respond next?
• C. Where do you go from here?
• D. Why haven’t we heard from you?

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.

5. A client with Crohn's disease is being cared for by a nurse. Which of the following food choices aligns with the recommended diet for clients with Crohn's disease?

• A. Vanilla milkshake
• B. Buttered popcorn
• C. Tossed green salad
• D. Toast with jelly

Correct answer: C

Rationale: The correct answer is a 'Tossed green salad.' Clients with Crohn's disease often benefit from a low-residue diet, which includes easily digestible foods like leafy green vegetables found in a tossed green salad. This type of diet helps minimize gastrointestinal symptoms. Choices A, B, and D are not ideal for clients with Crohn's disease. Vanilla milkshake, buttered popcorn, and toast with jelly may exacerbate symptoms due to their high fat, fiber, or sugar content, which can be harder to digest.

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