Nursing Elites

1. A client with cirrhosis and ascites is being cared for by a nurse. Which of the following interventions should the nurse include in the plan of care?

• A. Decrease the client's fluid intake.
• B. Increase the client's saturated fat intake.
• C. Increase the client's sodium intake.
• D. Decrease the client's carbohydrate intake.

Correct answer: D

Rationale: In a client with cirrhosis and ascites, decreasing carbohydrate intake is essential as it helps reduce the production of ascitic fluid. Excess carbohydrates can lead to fluid retention. Choices A, B, and C are incorrect. Decreasing fluid intake can worsen dehydration, increasing saturated fat intake is not recommended due to its impact on liver health, and increasing sodium intake can worsen fluid retention and exacerbate ascites in these clients.

2. What are the contraindications for using MI Paste?

• A. Children under six
• B. Individuals with a milk casein allergy
• C. Pregnant women
• D. Both A and B

Correct answer: D

Rationale: MI Paste is contraindicated in children under six and in individuals with a milk casein allergy. The reason is that MI Paste contains casein phosphopeptide, which is derived from milk. Therefore, it may cause allergic reactions in those who are sensitive to milk proteins. Pregnant women (Choice C) are not contraindicated for using MI Paste unless they have a known allergy to milk casein. Hence, the correct answer is 'D: Both A and B'.

3. A nurse is teaching an in-service about manifestations of hypoglycemia to a group of newly licensed nurses. Which of the following should the nurse include in the teaching?

• A. Blurred vision
• B. Vomiting
• C. Kussmaul respirations
• D. Bradycardia

Correct answer: A

Rationale: Corrected Rationale: Blurred vision is a common symptom of hypoglycemia and should be included in the teaching. Other manifestations like vomiting, Kussmaul respirations, and bradycardia are not typically associated with hypoglycemia. Vomiting is more commonly seen in conditions like food poisoning or gastrointestinal issues. Kussmaul respirations are deep and rapid respirations seen in metabolic acidosis, not hypoglycemia. Bradycardia is usually not a manifestation of hypoglycemia; tachycardia is more commonly associated with low blood sugar levels.

4. Which enzyme is most essential for the digestion of triglycerides found in butterfat?

• A. Gastric lipase
• B. Pepsin
• C. Mucus
• D. Intrinsic factor

Correct answer: A

Rationale: The correct answer is A: Gastric lipase. Gastric lipase is crucial for the digestion of short- and medium-chain triglycerides, such as those found in butterfat. Pepsin is involved in protein digestion, not lipid digestion. Mucus acts as a protective barrier in the stomach and does not play a direct role in lipid digestion. Intrinsic factor is involved in the absorption of vitamin B12 and is not related to the digestion of triglycerides.

5. If the child does not have ear problem, using IMCI, what should you as the nurse do?

• A. Check for ear discharge
• B. Check for tender swellings behind the ear
• C. Check for ear pain
• D. Go to the next question, check for malnutrition

Correct answer: A

Rationale: Patient safety and efficacy of care depend on actions rooted in established nursing protocols that consider both the immediate and long-term needs of the patient.

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