Nursing Elites

1. Protein-energy malnutrition (PEM) may be responsible for the increased incidence of noma and necrotizing ulcerative gingivitis (NUG) because these conditions are associated with depressed immune responses caused by nutritional deficiencies.

• A. Both the statement and the reason are correct and related
• B. Both the statement and the reason are correct but are not related
• C. The statement is correct, but the reason is not correct
• D. The statement is not correct, but the reason is correct

Correct answer: A

Rationale: The corrected question highlights that protein-energy malnutrition weakens the immune system, making individuals more susceptible to conditions like noma and NUG, which are linked to compromised immunity. Choice A is correct because the statement and reason are both accurate and directly related. Protein-energy malnutrition does result in depressed immune responses, which can predispose individuals to noma and NUG. Choice B is incorrect because the statement and reason are indeed related. Choice C is incorrect as both the statement and reason are accurate. Choice D is also incorrect as the statement is correct and directly supports the reason provided.

2. An advance directive known as a durable power of attorney involves appointing another person called a(n) _____ to act as the decision maker in the event of the patient's incapacitation.

• A. witness
• B. primary caregiver
• C. health care agent
• D. state proxy

Correct answer: C

Rationale: The correct answer is 'health care agent.' A health care agent is appointed through a durable power of attorney to make medical decisions on behalf of a patient who becomes incapacitated. The term 'witness' (choice A) is incorrect because a witness only observes the signing of the directive and does not make decisions. 'Primary caregiver' (choice B) is also incorrect as they may provide care but are not necessarily legally empowered to make decisions. 'State proxy' (choice D) is not commonly used in the context of advance directives or health care decision making, making it an incorrect choice.

3. Of the following neurotransmitters, which demonstrates inhibitory action, helps control mood and sleep, and inhibits pain pathways?

• A. Serotonin
• B. Enkephalin
• C. Norepinephrine
• D. Acetylcholine

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.

4. Considering the statement that communication is most effective when barriers are first removed, which of the following is recognized as an inhibiting factor in communication?

• A. Avoidance of universally accepted abbreviations
• B. Usage of incorrect grammar
• C. Poor handwriting
• D. Advanced age of the client

Correct answer: D

Rationale: The correct answer is 'D: Advanced age of the client.' Age can be a significant obstacle in communication due to factors such as hearing loss, cognitive decline, or memory issues, which all can hamper effective communication. Choices A, B, and C, while they may present challenges in communication, are not directly related to age and its influence on communication, making them incorrect. The issues presented by not using universally accepted abbreviations, incorrect grammar, and poor handwriting can be resolved through clarification, education, or the use of alternative communication methods, unlike the difficulties that can arise from advanced age.

5. In monitoring the patient in PACU, the nurse correctly identifies that checking the patient's vital signs is done every:

• A. 1 hour
• B. 5 minutes
• C. 15 minutes
• D. 30 minutes

Correct answer: A

Rationale: Correct Answer: A - Vital signs monitoring in the PACU (Post-Anesthesia Care Unit) is typically done every hour to closely monitor the patient's condition during the immediate postoperative period. This frequency allows the nurse to promptly identify any changes in the patient's vital signs and intervene as necessary. Choice B (5 minutes) is too frequent for routine vital signs monitoring in the PACU and may not allow for a comprehensive assessment of the patient's stability. Choice C (15 minutes) and Choice D (30 minutes) are also not in line with the standard practice of vital signs monitoring in the PACU, which is typically hourly.

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