Nursing Elites

1. A young adult asks the nurse about the normal cholesterol level. The nurse tells the client that the total cholesterol level should be maintained at less than:

• A. 140 mg/dL
• B. 200 mg/dL
• C. 250 mg/dL
• D. 300 mg/dL

Correct answer: B

Rationale: The correct answer is B: 200 mg/dL. A normal cholesterol value ranges between 140 and 199 mg/dL. Total cholesterol levels should ideally be maintained at 200 mg/dL or less to reduce the risk of cardiovascular diseases. Choices A, C, and D are incorrect as they exceed the recommended normal range for total cholesterol levels and may increase the risk of developing heart-related issues.

2. A client reports for a scheduled electroencephalogram (EEG). Which statement by the client indicates a need for additional preparation for the test?

• A. I didn’t shampoo my hair.
• B. I ate breakfast this morning.
• C. I didn’t take my anticonvulsant today.
• D. It was hard not to drink coffee this morning, but I knew that I couldn’t, so I didn’t.

Correct answer: A

Rationale: The correct answer is A. For an EEG, it is essential that the client's hair is clean, without any products like hairspray or gel, to ensure good electrode contact with the scalp. Choice B is not a concern as having breakfast is allowed before the test. Choice C, not taking an anticonvulsant, might be required for certain types of EEGs to capture accurate brain activity. Choice D, not drinking coffee, is not a specific requirement for an EEG preparation.

3. The healthcare provider is developing standards of care for a client with gastroesophageal reflux disease and wants to review current evidence for practice. Which one of the following resources will provide the most helpful information?

• A. A review in the Cochrane Library.
• B. A literature search in a database, such as the Cumulative Index to Nursing and Allied Health Literature (CINAHL).
• C. An online nursing textbook.
• D. The policy and procedure manual at the healthcare agency.

Correct answer: A

Rationale: The Cochrane Library provides systematic reviews of primary research in healthcare, making it a reliable resource for evidence-based practice. Choice B, a literature search in a database like CINAHL, may also be useful but does not guarantee the same level of systematic review and reliability as the Cochrane Library. Choice C, an online nursing textbook, may offer information but might not provide the most current or evidence-based practices. Choice D, the policy and procedure manual at the healthcare agency, is unlikely to offer the comprehensive evidence-based information needed for developing standards of care.

4. The nurse is caring for a client with chronic renal failure who is on a low-potassium diet. Which of the following foods should the client avoid?

• A. Bananas
• B. Potatoes
• C. Rice
• D. Apples

Correct answer: A

Rationale: Bananas are high in potassium content, which can lead to hyperkalemia in clients with chronic renal failure who are on a low-potassium diet. Therefore, it is crucial for these clients to avoid bananas. Potatoes, rice, and apples are lower in potassium compared to bananas and are generally considered safe for consumption in clients with chronic renal failure on a low-potassium diet.

5. A client with chronic obstructive pulmonary disease (COPD) who is beginning oxygen therapy asks the nurse why the flow rate cannot be increased to more than 2 L/min. The nurse responds that this would be harmful because it could:

• A. Be drying to nasal passages
• B. Decrease the client’s oxygen-based respiratory drive
• C. Increase the risk of pneumonia due to drier air passages
• D. Decrease the client’s carbon dioxide–based respiratory drive

Correct answer: B

Rationale: Increasing the oxygen flow rate beyond 2 L/min for a client with COPD can decrease the client's oxygen-based respiratory drive. In clients with COPD, the natural respiratory drive is based on the level of oxygen instead of carbon dioxide, as seen in healthy individuals. Increasing the oxygen level independently can suppress the drive to breathe, leading to respiratory failure. Choices A, C, and D are incorrect because drying of nasal passages, increased risk of pneumonia due to drier air passages, and decreasing the carbon dioxide-based respiratory drive are not the primary concerns associated with increasing the oxygen flow rate in a client with COPD.

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