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. When should a newborn transition to whole milk according to dietary teaching for breastfeeding parents?

• A. 6 months
• B. 8 months
• C. 10 months
• D. 12 months

Correct answer: D

Rationale: Breast milk or formula should be the primary source of nutrition for infants up to around 1 year of age. The transition to whole cow's milk is recommended at 12 months of age, not earlier. Introducing whole milk before 12 months can lead to digestive issues and nutrient deficiencies. Therefore, choices A, B, and C are incorrect as they suggest transitioning to whole milk before the recommended age of 12 months.

3. Which of the following amino acids are considered indispensable?

• A. Lysine
• B. Methionine
• C. Tryptophan
• D. Valine

Correct answer: A

Rationale: The correct answer is A: Lysine. Indispensable amino acids are those that the body cannot synthesize and must be obtained from the diet. Lysine, methionine, and tryptophan are all examples of indispensable amino acids. However, the question specifically asked for 3 out of the 9 indispensable amino acids, making 'Lysine' the correct choice. Choices B, C, and D are also indispensable amino acids but are not the focus of the question.

4. During blood administration, what is essential for the nurse to do in order to carefully monitor for adverse reactions?

• A. Stay with the client for the first 15 minutes of blood administration
• B. Stay with the client for the entire period of blood administration
• C. Run the infusion at a faster rate during the first 15 minutes
• D. Inform the client to notify the staff immediately for any adverse reaction

Correct answer: A

Rationale: In the context of blood administration, it's crucial for the nurse to stay with the client for the first 15 minutes. This is because most adverse reactions are likely to occur within this initial period. Monitoring the client closely during this time allows for immediate detection and response to any potential reactions. Choice B, staying with the client for the entire period of blood administration, is not typically feasible or necessary, although regular checks should be conducted. Running the infusion at a faster rate during the first 15 minutes (Choice C) is incorrect as this can actually increase the risk of adverse reactions. Informing the client to notify the staff immediately for any adverse reaction (Choice D) is an important practice, but it is not the most direct way for the nurse to monitor for adverse reactions.

5. Each of the following accurately describes aspects of the dietary reference intakes (DRIs) published by the Food and Nutrition Board of the Institute of Medicine (IOM) except one. Which one is the exception?

• A. The DRIs replace the older recommended daily allowances
• B. Current DRIs attempt to estimate required nutrients to improve long-term health
• C. DRIs specifically address individuals whose requirements are affected by a disease state
• D. The DRIs attempt to establish maximum safe levels of tolerance for nutrients

Correct answer: C

Rationale: The correct answer is C. DRIs are intended for the general population and do not specifically address disease states, which are managed with different clinical guidelines. Choice A is correct as DRIs have replaced the older recommended daily allowances. Choice B is correct as current DRIs aim to estimate the required nutrients for long-term health. Choice D is correct as DRIs also attempt to establish maximum safe levels of tolerance for nutrients.

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