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. Which hormone is produced in fat tissue and helps regulate body fat by suppressing appetite?

• A. glucagon
• B. ghrelin
• C. leptin
• D. insulin

Correct answer: C

Rationale: The correct answer is C, leptin. Leptin is a hormone produced by fat cells that helps regulate energy balance by suppressing hunger, thus aiding in the regulation of body fat. Glucagon (choice A) is a hormone that raises blood glucose levels, ghrelin (choice B) stimulates appetite, and insulin (choice D) regulates blood sugar levels and promotes glucose uptake.

3. The recommended treatment modality in clients with obsessive-compulsive disorder is:

• A. Psychotherapy
• B. Behavior therapy
• C. Aversion therapy
• D. Psychoanalysis

Correct answer: B

Rationale: The recommended treatment modality for clients with obsessive-compulsive disorder is Behavior Therapy, not Psychoanalysis. Behavior therapy, specifically exposure and response prevention, is considered the first-line treatment for OCD. This therapy focuses on changing the patterns of behavior that contribute to the disorder. Psychotherapy, although beneficial in some cases, is not as effective as behavior therapy for OCD. Aversion therapy involves associating a stimulus with a negative outcome to reduce the frequency of a specific behavior, which is not the primary approach for OCD.

4. The nurse is planning education about appropriate protein food choices for a client who has recently been prescribed a renal diet. Which protein food items should the nurse include in the education?

• A. Yogurt, seeds, and lentils
• B. Beef, bacon, and nuts
• C. Peanut butter, beans, and peas
• D. Poultry, eggs, and fish

Correct answer: D

Rationale: The correct answer is D: Poultry, eggs, and fish. These protein sources are high-quality proteins suitable for a renal diet as they provide essential amino acids without excessive amounts of potassium or phosphorus. Choice A, yogurt, seeds, and lentils, may be high in potassium and phosphorus, which could be restricted in a renal diet. Choice B, beef, bacon, and nuts, are also high in phosphorus and may not be ideal for a renal diet. Choice C, peanut butter, beans, and peas, are high in potassium and phosphorus, making them less suitable for a renal diet.

5. 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.

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