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. The nurse is working with a patient who recently had a stroke. The patient frequently chokes and coughs when eating and is having difficulty feeding herself. What is the best way to ensure adequate nutrition?

• A. to have an aide feed her at each meal
• B. to ask a family member to assist during meals
• C. to provide tube feedings for the patient
• D. to initiate TPN for the patient

Correct answer: C

Rationale: The best way to ensure adequate nutrition for a stroke patient who frequently chokes and coughs when eating and has difficulty feeding herself is to provide tube feedings. Tube feedings are a safe and effective method to deliver nutrition directly to the stomach or intestines, bypassing the swallowing mechanism, reducing the risk of aspiration. Having an aide feed her each meal (choice A) may not address the underlying issue of swallowing difficulty and aspiration risk. Asking a family member to be present at each meal (choice B) does not provide a definitive solution to the patient's nutritional needs. Placing the patient on total parenteral nutrition (TPN) (choice D) is a more invasive and typically reserved for patients who cannot tolerate enteral feedings or have non-functional gastrointestinal tracts.

3. Selective inattention is seen in which level of anxiety?

• A. Mild
• B. Moderate
• C. Severe
• D. Panic

Correct answer: D

Rationale: Selective inattention is a defense mechanism seen in panic-level anxiety. In panic anxiety, individuals may experience selective inattention, where they focus only on specific aspects and ignore others. Mild anxiety does not typically involve selective inattention as individuals can still function effectively. Moderate and severe anxiety may impair attention, but selective inattention is more characteristic of panic-level anxiety.

4. To successfully complete the tasks of older adulthood, an 85 year old who has been a widow for 25 years should be encouraged to:

• A. Invest her creative energies in promoting social welfare
• B. Redefine her role in the society and offer something and offer something of value
• C. Feel a sense of satisfaction in reflecting on her productive life
• D. Look to recapture the opportunities that were never started or completed

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 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.

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