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. A nurse is providing dietary teaching to a client who has a new diagnosis of gastroesophageal reflux disease. Which of the following foods or beverages should the nurse recommend to minimize heartburn?

• A. Orange juice
• B. Decaffeinated coffee
• C. Peppermint
• D. Potatoes

Correct answer: D

Rationale: Potatoes are bland and less likely to relax the lower esophageal sphincter, making them a suitable choice to minimize heartburn in clients with gastroesophageal reflux disease. Orange juice and peppermint are acidic and can exacerbate GERD symptoms, while coffee, even decaffeinated, can stimulate acid production and worsen heartburn.

3. Which dietary recommendation is most appropriate for a patient with gout?

• A. Increase protein intake
• B. Reduce carbohydrate intake
• C. Avoid purine-rich foods
• D. Increase calcium intake

Correct answer: C

Rationale: The most appropriate dietary recommendation for a patient with gout is to avoid purine-rich foods. Purine-rich foods such as red meat and shellfish can lead to increased uric acid levels in the body, triggering gout flare-ups. Increasing protein intake (Choice A) is not recommended as some high-protein foods are also high in purines. Reducing carbohydrate intake (Choice B) and increasing calcium intake (Choice D) are not directly related to managing gout symptoms.

4. Being in contact with reality and the environment is a function of the:

• A. conscience
• B. ego
• C. id
• D. super ego

Correct answer: B

Rationale: Being in contact with reality and the environment is a function of the ego. The ego is responsible for mediating between the id's basic desires, the superego's idealistic standards, and the real world. The conscience (not listed as a choice) is related to feelings of guilt or moral responsibility. The id represents primal instincts, and the superego represents the internalized ideals and moral standards.

5. A nurse is preparing a teaching plan for a client who has neutropenia as a result of radiation therapy for the treatment of lung cancer. Which of the following should the nurse plan to include in the teaching?

• A. Bottled water is an appropriate choice to increase fluid intake.
• B. The salad bar is a healthy choice when dining out.
• C. Soft-boiled eggs are an appropriate source of protein.
• D. Eating at a buffet is a good choice to increase caloric intake.

Correct answer: A

Rationale: In neutropenia, which is a low count of neutrophils, the client is at a high risk of infection. It is crucial to emphasize the importance of proper hydration to maintain overall health. Bottled water is a safe choice as it reduces the risk of exposure to contaminants that could further compromise the client's immune system. The other options, like the salad bar, soft-boiled eggs, and eating at a buffet, may not be suitable for a client with neutropenia due to the risk of bacterial contamination or exposure to pathogens that could lead to infections, which should be avoided.

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