Nursing Elites

1. A nurse is reviewing the laboratory results for a client who has a history of atherosclerosis and notes elevated cholesterol levels. Which of the following statements by the client indicates the nurse should plan follow-up teaching on a low-cholesterol diet?

• A. "I flavor my meat with lemon juice."?
• B. "I eat two eggs for breakfast each morning."?
• C. "I cook my food with canola oil."?
• D. "I take an omega-3 supplement daily."?

Correct answer: B

Rationale: The correct answer is B. Eggs are high in cholesterol, so someone with elevated cholesterol levels, especially with a history of atherosclerosis, should be cautious about egg consumption. Choices A, C, and D are not as concerning for cholesterol levels. Lemon juice, canola oil, and omega-3 supplements do not significantly impact cholesterol levels compared to consuming eggs regularly.

2. What information should a working mother who wants to continue breastfeeding her infant by occasionally pumping milk ahead of time be given to help her successfully maintain breastfeeding?

• A. Breast milk can be refrigerated for up to 4 days
• B. Breast milk stored in a deep freezer can be kept for up to 12 months
• C. Heating breast milk in the microwave can degrade its nutritional quality
• D. Breast milk can be expressed either by hand or with an electric pump

Correct answer: D

Rationale: The correct answer is D. This information is crucial as it informs the mother of her options for expressing milk, which is the first step in being able to store and later feed it to her child while she's away at work. Choice A has been corrected to state that breast milk can be refrigerated for up to 4 days, providing a more accurate storage timeframe. Choice B has been revised to indicate that breast milk stored in a deep freezer can be kept for up to 12 months, aligning with the recommended storage duration. Choice C now highlights that heating breast milk in the microwave can degrade its nutritional quality, emphasizing the importance of using proper methods for warming breast milk and avoiding potential harm to the baby's health and well-being.

3. What is a major feature of the therapeutic lifestyle changes (TLC) recommended for the treatment of high blood cholesterol?

• A. Avoiding all foods that contain cholesterol
• B. Reducing sodium intake to less than 2 g/day
• C. Limiting total fat intake to less than 30% of energy intake
• D. Limiting saturated fat intake to less than 7% of energy intake

Correct answer: D

Rationale: The correct answer is D, 'Limiting saturated fat intake to less than 7% of energy intake.' This is a central feature of the therapeutic lifestyle changes (TLC) recommended for treating high blood cholesterol. Saturated fats can increase low-density lipoprotein (LDL) cholesterol, a significant risk factor for heart disease. Choice A is incorrect because while it is recommended to limit cholesterol intake, it's not suggested to avoid all foods containing cholesterol entirely in the TLC. Choice B is also incorrect as although reducing sodium intake is beneficial for controlling blood pressure, it's not specifically targeted in the TLC for managing high cholesterol. Lastly, while limiting total fat intake is a healthy guideline, it's not as specific or effective as limiting saturated fat intake, making choice C also incorrect.

4. Which of the following vaccines is not done by intramuscular (IM) injection?

• A. Measles vaccine C. Hepa-B vaccine
• B. DPT D. Tetanus toxoids
• C.
• D.

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.

5. Which of the following interventions should be considered the highest priority when caring for June, who has hemiparesis secondary to a stroke?

• A. Position June in an upright lateral position
• B. Perform range of motion exercises
• C. Apply antiembolic stockings
• D. Use hand rolls or pillows for support

Correct answer: C

Rationale: The correct answer is C, 'Apply antiembolic stockings'. In the case of a patient who has experienced a stroke and is suffering from hemiparesis, the highest priority intervention is to prevent further complications such as deep vein thrombosis (DVT), which can be life-threatening. Antiembolic stockings are used to increase venous blood flow velocity and reduce the risk of DVT. Choice 'A', positioning June in an upright lateral position, while important for overall care, is not the highest priority. Choice 'B', performing range of motion exercises, is an important part of recovery but not the immediate priority. Choice 'D', using hand rolls or pillows for support, is also a valuable intervention but does not address the most pressing risk of further complications.

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