Nursing Elites

1. In an extreme situation and when no other resident or intern is available, should a nurse receive telephone orders, the order has to be correctly written and signed by the physician within:

• A. 24 hours
• B. 36 hours
• C. 48 hours
• D. 12 hours

Correct answer: B

Rationale: In an extreme situation where no other resident or intern is available, if a nurse receives telephone orders, the order has to be correctly written and signed by the physician within 36 hours. This time frame ensures timely documentation and validation of the orders. Choice A (24 hours) is too short a period for busy physicians to fulfill the task. Choice C (48 hours) is too long and delays the incorporation of physician orders into the patient's care plan. Choice D (12 hours) may not provide enough time for the physician to review and sign the order, especially in situations where immediate attention is not required.

2. Each of the following describes the physiologic roles of water, except one. Which is the exception?

• A. Acts as a solvent for chemical reactions.
• B. Maintains stability of body fluids.
• C. Enables transport of nutrients and excretion of waste.
• D. Regulates temperature by pooling as perspiration on skin.

Correct answer: D

Rationale: The correct answer is D. Water regulates body temperature by evaporating as perspiration from the skin, not by pooling. When sweat evaporates from the skin, it takes away heat, which helps cool the body. Choices A, B, and C are correct because water acts as a solvent for chemical reactions, maintains the stability of body fluids, and enables the transport of nutrients and excretion of waste, respectively.

3. What does oliguria lead to in patients with acute kidney injury?

• A. Hypophosphatemia and overgrowth of bone tissue
• B. An increase in blood potassium levels due to excessive excretion of parathyroid hormone
• C. Sodium retention and elevated levels of potassium
• D. Edema due to increased urine production

Correct answer: C

Rationale: In patients with acute kidney injury, oliguria (reduced urine output) often results in sodium retention and hyperkalemia (elevated levels of potassium). This is due to the kidneys' decreased capacity to excrete these substances. Choice A is incorrect because hypophosphatemia and overgrowth of bone tissue are not direct consequences of oliguria in acute kidney injury. Choice B is incorrect because an increase in blood potassium levels is not caused by excessive excretion of parathyroid hormone but rather by decreased excretion of potassium. Choice D is incorrect because edema is not caused by increased urine production but rather by fluid overload due to decreased urine output.

4. A client is being taught about following a low-cholesterol diet after coronary artery bypass grafting. Which of the following food choices reflects the client's understanding of these dietary instructions?

• A. Liver
• B. Milk
• C. BEANS
• D. Eggs

Correct answer: C

Rationale: Choosing beans as a food option indicates that the client understands the low-cholesterol diet instructions. Beans are a good source of fiber and plant-based protein, which can help lower cholesterol levels. On the other hand, liver and eggs are high in cholesterol and should be limited in a low-cholesterol diet. Milk, especially whole milk, can also be high in saturated fats and cholesterol, so it is not the best choice for a low-cholesterol diet.

5. The purpose of ECT in clients with depression is to:

• A. Stimulation in the brain to increase brain conduction and counteract depression
• B. Mainly Biologic, increasing the norepinephrine and serotonin level
• C. Creates a temporary brain damage that will increase blood flow to the brain
• D. Involves the conduction of electrical current to the brain to charge the neurons and combat depression

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.

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