Nursing Elites

1. Membership dropout generally occurs in group therapy after a member:

• A. Accomplishes his goal in joining the group
• B. Discovers that his feelings are shared by the group members
• C. Experiences feelings of frustration in the group
• D. Discusses personal concerns with group members

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.

2. A nurse is planning care for a toddler who has burns over 50% total body surface area. Which of the following actions should the nurse include in the plan of care?

• A. Administer enteral feedings
• B. Limit intake of vitamin C
• C. Limit dietary protein
• D. Administer insulin prior to meals

Correct answer: A

Rationale: Administering enteral feedings is crucial for ensuring adequate nutrition and supporting healing in toddlers with extensive burns. Burns over 50% total body surface area can lead to increased metabolic demands, making it essential to provide nutrition through enteral feedings to meet the child's needs for healing and recovery. Limiting intake of vitamin C or dietary protein would be detrimental in this scenario as the child requires increased amounts of nutrients to support healing. Administering insulin prior to meals is not indicated in this case as the priority is to provide adequate nutrition to promote healing.

3. Dietary fiber has been recommended for its possible benefits in reducing heart disease by lowering blood cholesterol. How is fiber thought to play its role in lowering blood cholesterol?

• A. Insoluble fiber binds with cholesterol in the large intestine and is excreted in feces
• B. Viscous fiber binds with bile in the intestine and is excreted in feces
• C. Soluble fiber binds with cholesterol in the blood and is excreted by the liver
• D. Insoluble fiber converts to bile in the large intestine and binds with cholesterol

Correct answer: B

Rationale: The correct answer is B. Viscous (soluble) fiber binds with bile acids in the intestine, which are then excreted. The liver must use cholesterol to make more bile acids, thereby lowering blood cholesterol levels. Choice A is incorrect as insoluble fiber does not bind with cholesterol in the large intestine. Choice C is incorrect as soluble fiber does not directly bind with cholesterol in the blood. Choice D is incorrect as insoluble fiber does not convert to bile in the large intestine to bind with cholesterol.

4. Which of the following nutrients deficiency may lead to a diabetes-like condition?

• A. chromium
• B. iron
• C. molybdenum
• D. selenium

Correct answer: A

Rationale: Chromium is essential for proper glucose metabolism. A deficiency in chromium can result in insulin resistance, which shares similarities with diabetes. Iron, molybdenum, and selenium deficiencies do not directly lead to a diabetes-like condition. Iron deficiency causes anemia, molybdenum deficiency is rare and can lead to specific metabolic issues, and selenium deficiency may result in thyroid problems but not a diabetes-like condition.

5. During the first 24 hours after the thermal injury, you should assess Sergio for:

• A. hypokalemia and hypernatremia
• B. hypokalemia and hyponatremia
• C. hyperkalemia and hyponatremia
• D. hyperkalemia and hypernatremia

Correct answer: D

Rationale: During the initial phase after a thermal injury, the major concern is the release of potassium due to cell damage, leading to hyperkalemia. Hypernatremia is not typically a primary concern in the immediate post-injury phase. Hyponatremia is less likely to occur initially after a burn injury. Therefore, the correct assessment for Sergio during the first 24 hours after the thermal injury would be hyperkalemia and hypernatremia.

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