Nursing Elites

1. Reducing the amount of trans fat in the diet is an effective method of decreasing the risk of CHD. Which food is most likely a source of trans fat?

• A. hot dogs
• B. whole milk
• C. fatty fish
• D. potato chips

Correct answer: D

Rationale: The correct answer is D: potato chips. Potato chips, especially when fried in hydrogenated oils, are a common source of trans fats, which are linked to an increased risk of coronary heart disease (CHD). Hot dogs (choice A) can also contain trans fats if made with processed meats and added fats. Whole milk (choice B) and fatty fish (choice C) do not typically contain trans fats, making them less likely sources compared to potato chips.

2. What happens when Mrs. Guevarra, a nurse, delegates aspects of the client's care to the nurse-aide, an unlicensed staff member?

• A. Mrs. Guevarra makes the assignment to instruct the staff member
• B. Mrs. Guevarra is assigning the responsibility to the aide but not the accountability for those tasks
• C. Mrs. Guevarra does not need to directly supervise or evaluate the aide
• D. Mrs. Guevarra must know how to perform the task being delegated

Correct answer: C

Rationale: The correct answer is C. While it is true that Mrs. Guevarra is delegating tasks to the nurse-aide, she does not necessarily have to directly supervise or evaluate the aide. She still retains the overall accountability for the care of the client, but direct supervision of the aide is not a requirement for delegation. Choice A is incorrect because the primary purpose of delegation is not instruction. Choice B is also incorrect because although Mrs. Guevarra is delegating tasks, she still retains accountability for those tasks. Finally, choice D is incorrect because the ability to perform the task being delegated is not a requirement for the delegator; the delegatee should have the necessary skills and knowledge to perform the delegated tasks.

3. What is a major feature of the therapeutic lifestyle changes (TLC) recommended for the treatment of high blood cholesterol?

• A. Avoiding all foods that contain cholesterol
• B. Reducing sodium intake to less than 2 g/day
• C. Limiting total fat intake to less than 30% of energy intake
• D. Limiting saturated fat intake to less than 7% of energy intake

Correct answer: D

Rationale: The correct answer is D, 'Limiting saturated fat intake to less than 7% of energy intake.' This is a central feature of the therapeutic lifestyle changes (TLC) recommended for treating high blood cholesterol. Saturated fats can increase low-density lipoprotein (LDL) cholesterol, a significant risk factor for heart disease. Choice A is incorrect because while it is recommended to limit cholesterol intake, it's not suggested to avoid all foods containing cholesterol entirely in the TLC. Choice B is also incorrect as although reducing sodium intake is beneficial for controlling blood pressure, it's not specifically targeted in the TLC for managing high cholesterol. Lastly, while limiting total fat intake is a healthy guideline, it's not as specific or effective as limiting saturated fat intake, making choice C also incorrect.

4. What are the manifestations of nephrotic syndrome?

• A. Dehydration
• B. Uremia
• C. Infection
• D. Low blood lipids

Correct answer: C

Rationale: Infection is a common manifestation of nephrotic syndrome. This is due to the loss of immunoglobulins in the urine, which weakens the body's immune defenses. Dehydration (Choice A) and uremia (Choice B) can be symptoms of kidney dysfunction but are not specific manifestations of nephrotic syndrome. Low blood lipids (Choice D) is incorrect as nephrotic syndrome typically results in high, not low, blood lipid levels due to the body's attempt to replace lost proteins.

5. The recommended daily fluid intake of patients maintained using hemodialysis is:

• A. 150 mL plus the volume of urinary output
• B. 500 mL plus the volume of urinary output
• C. 1000 mL plus the volume of urinary output
• D. 1500 mL plus the volume of urinary output

Correct answer: C

Rationale: The correct answer is C: 1000 mL plus the volume of urinary output. Fluid intake is typically restricted in hemodialysis patients to prevent fluid overload. The recommended daily fluid intake for these patients is 1000 mL plus any urinary output. Choice A (150 mL plus the volume of urinary output) is too low and would not provide enough fluid for these patients. Choice B (500 mL plus the volume of urinary output) is also insufficient. Choice D (1500 mL plus the volume of urinary output) is too high and may lead to fluid overload in hemodialysis patients.

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