Nursing Elites

1. A client is being prepared for placement of a catheter for total parenteral nutrition. Which of the following access sites should be planned for catheter insertion?

• A. Left antecubital vein
• B. Right subclavian vein
• C. Right femoral artery
• D. Left arm radial artery

Correct answer: B

Rationale: The correct answer is the Right subclavian vein. When preparing a client for placement of a catheter for total parenteral nutrition, the preferred access site for catheter insertion is the subclavian vein due to its large size, central location, and lower risk of infection compared to peripheral veins. The other options provided (Left antecubital vein, Right femoral artery, and Left arm radial artery) are not suitable access sites for central venous catheter insertion for total parenteral nutrition.

2. Why is atherosclerosis dangerous to arterial function?

• A. It diminishes central circulation
• B. It causes decreased blood pressure on artery walls
• C. It narrows the arterial lumen so a clot can easily block it
• D. It increases arterial elasticity

Correct answer: C

Rationale: Atherosclerosis is dangerous to arterial function because it narrows the arterial lumen, increasing the risk of a clot completely blocking the blood flow. This can lead to severe cardiovascular events such as heart attacks or strokes. Choice A is incorrect since atherosclerosis does not primarily diminish central circulation, but rather, it impedes local blood flow where the plaque is present. Choice B is also incorrect as atherosclerosis increases the pressure on artery walls due to the narrowed space for blood flow, not decrease it. Lastly, choice D is incorrect as atherosclerosis causes the arteries to lose their elasticity, not increase it.

3. Nancy blames God for her situation. She is easily provoked to tears and wants to be left alone, refusing to eat or talk to her family. A religious person before, she now refuses to pray or go to church stating that God has abandoned her. The nurse understands that Nancy is grieving for her self and is in the stage of:

• A. bargaining
• B. denial
• C. anger
• D. acceptance

Correct answer: D

Rationale: Understanding the underlying pathology and therapeutic techniques ensures that nursing care is not only reactive but also preventative, reducing the risk of complications.

4. During early tooth development, vitamin A deficiency leads to enamel hypoplasia and defective dentin formation. Because of its effect on soft tissues and bone, vitamin A contributes to normal spacing of teeth.

• A. Both statements are true.
• B. Both statements are false.
• C. The first statement is true; the second is false.
• D. The first statement is false; the second is true.

Correct answer: A

Rationale: Both statements are true. The effect of vitamin A on the growth of soft tissues and bones naturally extends to the teeth and surrounding structures. Enamel hypoplasia, involving defective enamel matrix and incomplete calcification of enamel and dentin, can be due to vitamin A deficiency. The effect of this vitamin upon surrounding bone directly affects spacing patterns of the teeth within the bone and dentition. Choice A is correct because both statements accurately describe the influence of vitamin A on tooth development. Choices B, C, and D are incorrect as they do not reflect the accuracy of the statements provided.

5. Baby John develops hyperbilirubinemia. What is a method used to treat hyperbilirubinemia in a newborn?

• A. Keeping infants in a warm and dark environment
• B. Administration of cardiovascular stimulant
• C. Gentle exercise to stop muscle breakdown
• D. Early feeding to speed passage of meconium

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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