Nursing Elites

1. A healthcare professional is preparing a list of resources in a community where nutritional status is significantly influenced by economics. What should the professional recommend?

• A. Public service announcement on healthy eating
• B. Educational programs on food safety
• C. The MyPyramid food guidance system
• D. The Supplemental Nutrition Assistance Program (SNAP)

Correct answer: D

Rationale: The correct answer is D, the Supplemental Nutrition Assistance Program (SNAP). SNAP provides financial assistance to help low-income individuals purchase food, directly addressing economic barriers to nutrition. Choices A, B, and C do not directly address the economic aspect of the community's nutritional status. A public service announcement on healthy eating may raise awareness but does not provide financial assistance. Educational programs on food safety focus on a different aspect of nutrition. The MyPyramid food guidance system is a tool for healthy eating but does not address the economic challenges faced by the community.

2. 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.

3. Clients may benefit from slightly higher fat intakes than are normally recommended if they have:

• A. congestive heart failure
• B. cerebrovascular accident
• C. peripheral vascular disease
• D. chronic obstructive pulmonary disease

Correct answer: D

Rationale: In chronic obstructive pulmonary disease (COPD), higher fat intake can be beneficial because it provides more calories with less respiratory burden compared to carbohydrates. Choices A, B, and C are incorrect because congestive heart failure, cerebrovascular accident, and peripheral vascular disease do not specifically benefit from higher fat intakes as in COPD.

4. You are taking care of critically ill client and the doctor in charge calls to order a DNR (do not resuscitate) for the client. Which of the following is the appropriate action when getting DNR order over the phone?

• A. Have the registered nurse, family spokesperson, nurse supervisor and doctor sign
• B. Have 2 nurse validate the phone order, both nurses sign the order and the doctor should sign his order within 24
• C. Have the registered nurse, family and doctor sign the order
• D. Have 1 nurse take the order and sign it and have the doctor sign it within 24 hours

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.

5. Electrolytes create _____, which is caused by water following electrolytes within or between cells.

• A. energy
• B. active transport
• C. passive diffusion
• D. osmotic pressure

Correct answer: D

Rationale: Osmotic pressure is the force that drives water movement across cell membranes due to the presence of electrolytes, helping to balance fluid levels in the body. Choice A, 'energy,' is incorrect as electrolytes do not directly create energy. Choice B, 'active transport,' refers to the movement of molecules across a cell membrane requiring energy, not the movement of water. Choice C, 'passive diffusion,' is the process by which substances move from an area of higher concentration to lower concentration, not related to the movement of water following electrolytes.

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