Nursing Elites

1. An advance directive known as a durable power of attorney involves appointing another person called a(n) _____ to act as the decision maker in the event of the patient's incapacitation.

• A. witness
• B. primary caregiver
• C. health care agent
• D. state proxy

Correct answer: C

Rationale: The correct answer is 'health care agent.' A health care agent is appointed through a durable power of attorney to make medical decisions on behalf of a patient who becomes incapacitated. The term 'witness' (choice A) is incorrect because a witness only observes the signing of the directive and does not make decisions. 'Primary caregiver' (choice B) is also incorrect as they may provide care but are not necessarily legally empowered to make decisions. 'State proxy' (choice D) is not commonly used in the context of advance directives or health care decision making, making it an incorrect choice.

2. Which vitamin is essential for proper blood clotting?

• A. Vitamin A
• B. Vitamin E
• C. Vitamin K
• D. Vitamin C

Correct answer: C

Rationale: Vitamin K is vital for the synthesis of clotting factors, which are necessary for proper blood clotting. Vitamin A (Choice A) is important for vision and skin health, not blood clotting. Vitamin E (Choice B) is an antioxidant that helps protect cells from damage but is not directly involved in blood clotting. Vitamin C (Choice D) is essential for collagen synthesis and a healthy immune system, but it does not play a direct role in blood clotting.

3. In conducting a cleansing enema, how does the nurse position the client?

• A. Right lateral position
• B. Left lateral position
• C. Right Sim's position
• D. Left Sim's position

Correct answer: B

Rationale: In preparing a patient for a cleansing enema, the nurse typically positions the patient in the left lateral position. This position allows for the best flow of the solution due to the anatomical configuration of the colon. The right lateral position, right Sim's position, and left Sim's position are not typically used for this procedure. The rationale provided initially is incorrect as it pertains to lung expansion and postural drainage, which are not relevant to a cleansing enema procedure.

4. When carbohydrates are eliminated from the diet to lose weight, which nutrients are most likely to become insufficient?

• A. Iron, fiber, and protein
• B. Iron, fiber, and vitamin K
• C. Vitamin A and vitamin C
• D. Iron, fiber, and B vitamins

Correct answer: D

Rationale: Iron, fiber, and B vitamins are most likely to become insufficient when carbohydrates are eliminated from the diet to lose weight. Carbohydrates are a primary source of B vitamins and fiber in the diet. Iron can also be obtained from plant-based sources like legumes and whole grains, which are often eliminated when carbohydrates are restricted. Choices A, B, and C are incorrect because protein, vitamin K, vitamin A, and vitamin C are not primarily sourced from carbohydrates and are less likely to become insufficient solely due to carbohydrate elimination.

5. An emerging technique in screening for Breast Cancer in developing countries like the Philippines is:

• A. Mammography once a year starting at the age of 50
• B. Clinical BSE Once a year
• C. BSE Once a month
• D. Pap smear starting at the age of 18 or earlier if sexually active

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.

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