Nursing Elites

1. During the acute phase of a burn, the priority nursing intervention in caring for this client is:

• A. Prevention of infection
• B. Pain management
• C. Prevention of bleeding
• D. Fluid resuscitation

Correct answer: D

Rationale: During the acute phase of a burn, fluid resuscitation is the priority nursing intervention. This phase is characterized by fluid loss and the risk of hypovolemic shock. Administering fluids is crucial to maintain perfusion and prevent complications such as organ failure. While prevention of infection, pain management, and prevention of bleeding are important aspects of burn care, fluid resuscitation takes precedence in the acute phase to stabilize the client's condition and prevent further damage.

2. Which of the following are examples of mechanical digestion? Select all that apply.

• A. Heat
• B. Segmentation
• C. Option B and D
• D. Peristalsis

Correct answer: C

Rationale: Mechanical digestion involves physical movements that break down food in the digestive tract. Segmentation (choice B) and peristalsis (choice D), which are both movements of the muscles in the digestive tract, are examples of this type of digestion. Heat (choice A), on the other hand, is related to chemical digestion, not mechanical digestion. Therefore, choice C (Option B and D) is the correct answer as it includes both examples of mechanical digestion provided in the choices. Choices A and D are incorrect because heat (choice A) is not a mechanical digestion process, and peristalsis (choice D) is a movement that helps propel food along the digestive tract but is not directly involved in breaking down food physically.

3. A nurse is providing teaching to a group of adult athletes about preventing the effects of dehydration on the body. Which of the following manifestations should the nurse include in the teaching?

• A. Impaired motor control
• B. Drop in body temperature during exercise
• C. Increase in appetite
• D. Decreased resting heart rate

Correct answer: A

Rationale: Dehydration can lead to impaired motor control due to electrolyte imbalances affecting muscle function. Choices B, C, and D are incorrect. Dehydration typically causes an increase in body temperature during exercise, not a drop. Dehydration is more likely to suppress appetite, leading to a decrease rather than an increase in appetite. Also, dehydration often results in an increased heart rate rather than a decreased resting heart rate.

4. What is the recommended dietary intervention for a patient with hyperlipidemia?

• A. Increase saturated fat intake
• B. Reduce fiber intake
• C. Increase dietary fiber intake
• D. Reduce protein intake

Correct answer: C

Rationale: Increasing dietary fiber can help reduce cholesterol levels in patients with hyperlipidemia.

5. In a patient with liver cirrhosis, weight gain due to fluid retention can mask the symptoms of what condition?

• A. Liver failure
• B. Gallbladder disease
• C. Heart failure
• D. Protein-Energy Malnutrition (PEM)

Correct answer: D

Rationale: In a patient with liver cirrhosis, weight gain due to fluid retention can mask Protein-Energy Malnutrition (PEM) symptoms. This can lead to an increase in weight, making it challenging to identify weight loss or muscle wasting associated with PEM. Therefore, option D is correct. Options A, B, and C are incorrect because fluid retention and weight gain related to liver cirrhosis do not necessarily hide the symptoms of liver failure, gallbladder disease, or heart failure.

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