Nursing Elites

1. Medication for treating high blood cholesterol levels should not be used for most people unless:

• A. The patient has at least three major risk factors for coronary heart disease
• B. The patient has been experiencing symptoms of coronary heart disease for at least three months
• C. The patient's medical insurance covers prescription drugs
• D. Treatment with Therapeutic Lifestyle Changes (TLC) alone is unsuccessful after three months

Correct answer: D

Rationale: The correct answer is choice D because medication for high cholesterol is typically not considered unless Therapeutic Lifestyle Changes (TLC), which include diet and exercise, have not proven effective after a three-month period. This approach ensures that lifestyle modifications are given a fair chance to lower cholesterol levels before resorting to medication. Choice A is incorrect because the number of risk factors for coronary heart disease does not dictate when to begin medication; it is about the effectiveness of lifestyle changes. Choice B is incorrect as the duration of coronary heart disease symptoms does not determine when to start medication; the focus is on the response to TLC. Choice C is incorrect because the coverage of prescription drugs by the patient's insurance does not influence the medical decision to use medication for high cholesterol; it is based on medical necessity and effectiveness of prior interventions.

2. Maria’s statement “Bow down before me! I am the holy mother of Christ! I am the blessed Virgin Mary!” is an example of:

• A. Delusion of grandeur
• B. Visual Hallucination
• C. Religious delusion
• D. Auditory Hallcucination

Correct answer: B

Rationale: Nursing interventions should be grounded in a deep understanding of the physiological processes involved, ensuring that care provided is both effective and efficient.

3. Before Dianne performs the formal research study, what do you call the pre-testing, small-scale trial run to determine the effectiveness of data collection and methodological problems that might be encountered?

• A. Sampling
• B. Pre-testing
• C. Pre-Study
• D. Pilot Study

Correct answer: D

Rationale: The correct answer is 'Pilot Study.' A pilot study is a small-scale trial run conducted before the formal research study to identify and address any issues related to data collection and methodology. This helps in determining the effectiveness of the research process and identifying potential problems that may arise. Choice A, 'Sampling,' refers to the process of selecting a subset of individuals from a larger population for research. Choice B, 'Pre-testing,' simply involves testing something before the main testing phase. Choice C, 'Pre-Study,' is not a commonly used term in research methodology and does not specifically refer to the small-scale trial run described in the question.

4. What food assistance program provides a food debit card for older adults with low incomes?

• A. the OAA Nutrition Program
• B. Meals on Wheels
• C. the Supplemental Nutrition Assistance Program
• D. the Emergency Food Assistance Program

Correct answer: C

Rationale: The correct answer is C: the Supplemental Nutrition Assistance Program (SNAP). SNAP provides a food debit card to assist low-income individuals, including older adults, in purchasing food. Choice A, the OAA Nutrition Program, is incorrect as it refers to a different program specifically focused on providing nutrition services to older adults. Choice B, Meals on Wheels, is incorrect as it is a meal delivery service for homebound individuals rather than a food debit card program. Choice D, the Emergency Food Assistance Program, is incorrect as it typically involves the distribution of emergency food supplies rather than providing a food debit card.

5. A client with pre-dialysis end-stage kidney disease is being taught about diet. Which of the following instructions should the nurse include?

• A. Increase intake of dietary phosphorus.
• B. Eliminate foods high in protein from your diet.
• C. Reduce intake of foods high in potassium.
• D. Increase intake of sodium-containing foods.

Correct answer: C

Rationale: In pre-dialysis end-stage kidney disease, reducing intake of foods high in potassium is crucial as impaired kidney function can lead to potassium buildup in the blood, which can be dangerous. High potassium levels can cause irregular heartbeats and even cardiac arrest. Therefore, advising the client to reduce potassium-rich foods is essential to prevent complications. Choices A, B, and D are incorrect. Increasing dietary phosphorus, eliminating foods high in protein, or increasing sodium-containing foods are not appropriate recommendations for a client with pre-dialysis end-stage kidney disease as they can exacerbate the condition.

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