Nursing Elites

1. Why does Anita stand in front of the mirror while performing a Breast Self-Examination (BSE)?

• A. To check for unusual discharges from the breast
• B. To check for any obvious malignancy
• C. To observe the size and contour of the breast
• D. To check for thickness and lumps in the breast

Correct answer: C

Rationale: When performing a Breast Self-Examination (BSE), one of the reasons for standing in front of a mirror is to observe the size and contour of the breast (Choice C). This helps in identifying any visible changes or abnormalities such as dimpling, puckering, or changes in the size and shape of the breasts. While unusual discharges (Choice A) and thickness or lumps (Choice D) can be part of the changes a person might notice during a BSE, these are typically identified by palpation or by squeezing the nipple for discharge, not by just looking in the mirror. Choice B, checking for obvious malignancy, is too vague and not specific enough as malignancy is often not visible to the naked eye.

2. Which of the following is a factor that affects Basal Metabolic Rate (BMR)?

• A. Age
• B. Sleep
• C. Fasting/Starvation
• D. All of the above

Correct answer: D

Rationale: All the listed options (Age, Sleep, Fasting/Starvation, Activity Level) are factors that can affect a person's Basal Metabolic Rate (BMR). BMR is the number of calories your body needs to accomplish its most basic (basal) life-sustaining functions. Age can affect BMR as metabolism slows with age. Sleep can influence BMR as metabolism slows during sleep. Fasting or starvation can decrease BMR as the body conserves energy. Activity level can also influence BMR; the more active you are, the higher your BMR, as your body requires more energy for physical activities.

3. A client newly diagnosed with hypertension is receiving teaching about the Mediterranean diet from a nurse. Which of the following statements by the client indicates a need for further teaching?

• A. I will limit my intake of red meat to twice weekly.
• B. I can have dairy in moderate portions daily.
• C. I can have fish two times a week.
• D. I can drink wine in moderation.

Correct answer: D

Rationale: The correct answer is D. Patients with hypertension should be advised to limit alcohol consumption, including wine, to help manage their blood pressure. Choices A, B, and C are all consistent with the Mediterranean diet and are appropriate for a client with hypertension. Reducing red meat intake, consuming dairy in moderate portions, and having fish regularly align with the principles of this heart-healthy eating pattern.

4. What health instruction will enhance regulation of a colostomy (defecation) of clients?

• A. Irrigate after lunch everyday
• B. Eat fruits and vegetables in all three meals
• C. Eat balanced meals at regular intervals
• D. Restrict exercise to walking only

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.

5. In which type of shock does the patient experience a mismatch of blood flow to the cells?

• A. Distributive
• B. Cardiogenic
• C. Hypovolemic
• D. Septic

Correct answer: A

Rationale: The correct answer is A: Distributive shock. Distributive shock is characterized by a widespread increase in vascular permeability leading to a relative hypovolemia and a mismatch of blood flow to the cells. Choice B, Cardiogenic shock, is due to the heart's inability to pump effectively. Choice C, Hypovolemic shock, results from a decrease in intravascular volume. Choice D, Septic shock, is caused by a systemic response to infection.

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