Nursing Elites

1. Persons experiencing crisis becomes passive and submissive. As a nurse, you know that the best approach in crisis intervention is to be:

• A. Active and Directive
• B. Passive friendliness
• C. Active friendliness
• D. Firm kindness

Correct answer: C

Rationale: Effective nursing care involves comprehensive assessments that address all aspects of a patient's condition, ensuring that interventions are appropriately targeted and outcomes are optimized.

2. A nurse is instructing teenage girls on the importance of adequate calcium intake throughout their life span to prevent complications. Which complication should the nurse include in the teaching?

• A. Goiter
• B. Osteoporosis
• C. Heart disease
• D. Dental caries

Correct answer: B

Rationale: The correct answer is B: Osteoporosis. Adequate calcium intake throughout life helps prevent osteoporosis, a condition characterized by weak and brittle bones, which is common in older adults. Goiter is caused by an iodine deficiency, not calcium. Heart disease is more related to factors like cholesterol and blood pressure. Dental caries are primarily influenced by oral hygiene and sugar intake, not just calcium.

3. What level of sodium restriction would be included as part of nutrition therapy for heart failure?

• A. Less than 500 mg per day
• B. 1000 mg to 1500 mg per day
• C. 1500 mg to 3000 mg per day
• D. 3000 to 3500 mg per day

Correct answer: C

Rationale: The correct answer is 1500 mg to 3000 mg per day. This is the level of sodium restriction typically recommended for heart failure patients. It helps manage fluid retention and reduce blood pressure, which are both crucial in treating heart failure. A sodium intake of less than 500 mg per day (Choice A) might be too restrictive and is not typically recommended. Similarly, an intake of 1000 mg to 1500 mg per day (Choice B) falls short of the recommended range. Lastly, an intake of 3000 to 3500 mg per day (Choice D) exceeds the recommended upper limit, potentially exacerbating fluid retention and high blood pressure.

4. Which of the following actions would be of highest priority with regards to the external shunt?

• A. Avoid taking blood pressure or blood sample from the arm with the shunt
• B. Instruct the patient not to exercise the arm with the shunt
• C. Heparinize the shunt daily
• D. Change the dressing of the shunt daily

Correct answer: C

Rationale: Heparinizing the shunt daily (choice C) is the highest priority action as it prevents the formation of blood clots that can occlude the shunt, leading to potential complications such as thrombosis. Avoiding taking blood pressure or blood samples from the arm with the shunt (choice A) is also important, but secondary to heparinizing the shunt. Similarly, instructing the patient not to exercise the arm with the shunt (choice B) can help prevent unnecessary strain on the shunt, but it is not as critical as preventing clot formation. Changing the dressing of the shunt daily (choice D) is a standard nursing care practice to prevent infection, but again, it is not as critical as ensuring the shunt remains patent through daily heparinization.

5. You are to apply a transdermal patch of nitoglycerin to your client. The following are important guidelines to observe EXCEPT:

• A. Apply to hairless clean area of the skin not subject to much wrinkling
• B. Patches may be applied to distal part of the extremities like forearm
• C. Change application and site regularly to prevent irritation of the skin
• D. Wear gloves to avoid any medication on your hand

Correct answer: D

Rationale: Understanding the underlying pathology and therapeutic techniques ensures that nursing care is not only reactive but also preventative, reducing the risk of complications.

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