Nursing Elites

1. For an incontinent elderly client who frequently wets his bed and develops redness and skin excoriation at the perianal area, what is the best nursing goal?

• A. Ensure that the bed linen is always dry
• B. Frequently check the bed for wetness and keep it dry
• C. Place a rubber sheet under the client's buttocks
• D. Keep the patient clean and dry

Correct answer: A

Rationale: The best nursing goal for an incontinent elderly client with skin excoriation is to ensure that the bed linen is always dry. This helps in preventing further skin breakdown and promoting skin integrity. Choice B, to frequently check the bed for wetness and keep it dry, may not address the issue of prevention if the linen is not consistently dry. Choice C, placing a rubber sheet under the client's buttocks, focuses more on protecting the mattress rather than addressing the client's skin condition directly. Choice D, keeping the patient clean and dry, is important but does not specifically address the preventive aspect of maintaining dry bed linen.

2. Patients with kidney stones should increase their intake of:

• A. fluids
• B. vitamin C
• C. oxalates
• D. protein

Correct answer: A

Rationale: Patients with kidney stones should increase their intake of fluids. Increasing fluid intake helps to dilute the urine and reduce the risk of kidney stones forming by flushing out minerals that can crystallize. This promotes the passage of small stones and helps prevent the formation of new ones. Vitamin C and protein intake should be moderated as excessive consumption may lead to the formation of certain types of kidney stones. Oxalates should be limited in the diet as they can contribute to the formation of calcium oxalate stones, a common type of kidney stone.

3. Any disease that produces ____ malabsorption can bring about deficiencies of vitamins A, D, E, and K.

• A. water
• B. protein
• C. fat
• D. carbs

Correct answer: C

Rationale: Vitamins A, D, E, and K are fat-soluble, meaning they require fat for absorption. Diseases that cause fat malabsorption can lead to deficiencies in these vitamins.

4. In kidney disease, which mineral should a patient limit intake of?

• A. Calcium
• B. Magnesium
• C. Phosphorus
• D. Potassium

Correct answer: C

Rationale: In kidney disease, patients are advised to limit the intake of phosphorus. High levels of phosphorus can be problematic as the kidneys may not be able to effectively filter it out, leading to bone health issues. Calcium (Choice A) is important for bone health, but its restriction is not typically necessary in kidney disease. Magnesium (Choice B) and potassium (Choice D) restrictions may be required in certain cases of kidney disease, but phosphorus is the mineral most commonly limited due to its impact on bone health.

5. A Hazard Analysis and Critical Control Points (HACCP) program would address which element of food service?

• A. cleaning and disinfecting of utensils
• B. developing healthy menus
• C. controlling patient calorie intake
• D. prescribing diets for patients with swallowing problems

Correct answer: A

Rationale: The correct answer is A. Hazard Analysis and Critical Control Points (HACCP) programs are designed to ensure food safety by identifying and controlling potential hazards. This includes addressing the cleaning and disinfecting of utensils to prevent contamination and maintain safe food handling practices. Choices B, C, and D are incorrect because HACCP primarily focuses on preventing food safety hazards rather than developing menus, controlling calorie intake, or prescribing diets for specific medical conditions.

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