Nursing Elites

1. An appropriate nursing diagnosis for clients in the acute manic phase of bipolar disorder is:

• A. Risk for injury directed to self
• B. Risk for injury directed to others
• C. Impaired nutrition less than body requirements
• D. Ineffective individual coping

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.

2. A nurse is providing anticipatory guidance to a client who has Phenylketonuria (PKU) and is planning a pregnancy. Which of the following information should the nurse include in the discussion?

• A. Diet sodas should not be consumed more than two or three times a week.
• B. Serum bilirubin should be monitored once or twice a month during pregnancy.
• C. Breastfeeding will not prevent your baby from developing PKU.
• D. A low-protein diet should be followed for three months before conception.

Correct answer: D

Rationale: A low-protein diet should be followed for three months before conception in individuals with PKU who are planning a pregnancy. This diet helps manage PKU by reducing phenylalanine levels, which is crucial for maternal and fetal health. Choices A, B, and C are incorrect. Choice A is not directly related to managing PKU, choice B focuses on a different aspect of care during pregnancy, and choice C is inaccurate as breastfeeding will not prevent a baby from developing PKU.

3. What is the approximate energy value of alcohol?

• A. 3 kcal/g
• B. 7 kcal/g
• C. 10 kcal/g
• D. 25 kcal/g

Correct answer: B

Rationale: The correct answer is B: 7 kcal/g. Alcohol provides approximately 7 kilocalories per gram, making it a significant source of energy or 'empty calories' in the diet that do not contain any nutrients. 'Empty calories' refer to the calorie content without the presence of essential nutrients. Choices A, C, and D are incorrect. The energy values of 3 kcal/g, 10 kcal/g, and 25 kcal/g are not accurate for alcohol; instead, they may pertain to other nutrients such as carbohydrates (approximately 4 kcal/g), fats (approximately 9 kcal/g), and oils (approximately 9 kcal/g).

4. A nurse is caring for a client who is to receive a mechanically altered diet. Which of the following client food choices necessitates intervention by the nurse?

• A. Scrambled eggs
• B. Cottage cheese
• C. Piece of wheat toast
• D. Sliced banana

Correct answer: D

Rationale: The correct answer is 'Sliced banana.' A mechanically altered diet is designed for clients who have difficulty chewing or swallowing. Sliced bananas, due to their texture and potential choking hazard for clients with swallowing difficulties, would necessitate intervention by the nurse. Scrambled eggs, cottage cheese, and a piece of wheat toast are softer and safer options for clients on a mechanically altered diet, making them appropriate choices.

5. A nurse is teaching an in-service about manifestations of hypoglycemia to a group of newly licensed nurses. Which of the following should the nurse include in the teaching?

• A. Blurred vision
• B. Vomiting
• C. Kussmaul respirations
• D. Bradycardia

Correct answer: A

Rationale: Corrected Rationale: Blurred vision is a common symptom of hypoglycemia and should be included in the teaching. Other manifestations like vomiting, Kussmaul respirations, and bradycardia are not typically associated with hypoglycemia. Vomiting is more commonly seen in conditions like food poisoning or gastrointestinal issues. Kussmaul respirations are deep and rapid respirations seen in metabolic acidosis, not hypoglycemia. Bradycardia is usually not a manifestation of hypoglycemia; tachycardia is more commonly associated with low blood sugar levels.

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