Nursing Elites

1. During the phallic stage, with which parent must the child identify?

• A. The same-sex parent
• B. The opposite-sex parent
• C. The mother or the primary caregiver
• D. Both parents

Correct answer: A

Rationale: According to Freud's psychosexual development theory, during the phallic stage (approximately ages 3 to 6), the child starts to identify with the parent of the same sex. This identification is a crucial part of the child's development and is believed to influence their adult behavior. The process involves the child adopting the characteristics, attitudes, and values of the same-sex parent. Choice B, C, and D are incorrect as they do not align with Freud's theory of the phallic stage of psychosexual development.

2. In which condition is underconsumption of fat not a concern?

• A. Malabsorption syndromes
• B. Cystic fibrosis
• C. AIDS
• D. Hypertension

Correct answer: D

Rationale: The correct answer is D, Hypertension. Hypertension is not typically associated with underconsumption of fat; instead, it is more related to the consumption of excess fat, especially saturated and trans fats, which can contribute to increased blood pressure. Malabsorption syndromes, cystic fibrosis, and AIDS are conditions where underconsumption of fat can be a concern due to various reasons such as malabsorption issues, pancreatic insufficiency, or increased energy needs.

3. A nurse is planning care for a client who has ascites secondary to liver disease. Which of the following interventions should the nurse include in the plan of care?

• A. Reduce complex carbohydrates to 30% of total calories.
• B. Restrict protein intake to less than 0.8 g/kg/day.
• C. Decrease daily caloric intake by 20%.
• D. Limit sodium to 2000 mg or less per day.

Correct answer: D

Rationale: The correct answer is to limit sodium to 2000 mg or less per day. Ascites, which is the abnormal accumulation of fluid in the abdominal cavity, is commonly associated with liver disease. Limiting sodium intake helps manage fluid retention by reducing the fluid accumulation in the abdomen. Choices A, B, and C are incorrect because reducing complex carbohydrates, restricting protein intake, or decreasing caloric intake are not the primary interventions for managing ascites in liver disease.

4. Which of the following actions would be of highest priority with regards to the external shunt?

• A. Avoid taking blood pressure or blood sample from the arm with the shunt
• B. Instruct the patient not to exercise the arm with the shunt
• C. Heparinize the shunt daily
• D. Change the dressing of the shunt daily

Correct answer: C

Rationale: Heparinizing the shunt daily (choice C) is the highest priority action as it prevents the formation of blood clots that can occlude the shunt, leading to potential complications such as thrombosis. Avoiding taking blood pressure or blood samples from the arm with the shunt (choice A) is also important, but secondary to heparinizing the shunt. Similarly, instructing the patient not to exercise the arm with the shunt (choice B) can help prevent unnecessary strain on the shunt, but it is not as critical as preventing clot formation. Changing the dressing of the shunt daily (choice D) is a standard nursing care practice to prevent infection, but again, it is not as critical as ensuring the shunt remains patent through daily heparinization.

5. When can a patient's medical record become a potential issue for the doctor or nurse?

• A. When the record is extensive
• B. When a medical record is subpoenaed in court
• C. When it is missing
• D. When the medical record is inaccurate, incomplete, or inadequate

Correct answer: D

Rationale: The correct answer is D. A medical record becomes a potential issue for a doctor or a nurse when it is inaccurate, incomplete, or inadequate. This is because a medical record is a key tool for healthcare professionals to track a patient's history, treatment, and progress. If the record is not accurate or complete, it can lead to misdiagnosis, incorrect treatment, or other potential problems in patient care. While missing records (Choice C) could be a problem, they do not directly implicate the doctor or nurse in the same way that inaccurate or inadequate records do. An extensive record (Choice A) or a record being subpoenaed in court (Choice B) are not inherently problematic for healthcare professionals and do not necessarily reflect negatively on their work.

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