Nursing Elites

1. What is the fundamental difference between nursing diagnoses and collaborative problems?

• A. Collaborative problems are managed by nurses using physician-prescribed interventions.
• B. Collaborative problems can be addressed by independent nursing interventions.
• C. Physician-prescribed interventions are incorporated into nursing diagnoses.
• D. Nursing diagnoses include physiologic complications that nurses monitor to detect status changes.

Correct answer: B

Rationale: The correct answer is B, as collaborative problems necessitate the collective expertise and skills of numerous healthcare professionals, including nurses. These problems can be dealt with through independent nursing interventions in cooperation with other team members. Option A is incorrect because collaborative problems aren't strictly managed with physician-prescribed interventions. Option C is incorrect because nursing diagnoses aim at identifying and treating actual or potential health issues, rather than merely integrating physician-prescribed interventions. Option D is incorrect because nursing diagnoses aim at identifying patient issues, not solely physiologic complications, and guide the necessary nursing care, not just monitor for changes.

2. In which type of shock does the patient experience a mismatch of blood flow to the cells?

• A. Distributive
• B. Cardiogenic
• C. Hypovolemic
• D. Septic

Correct answer: A

Rationale: The correct answer is A: Distributive shock. Distributive shock is characterized by a widespread increase in vascular permeability leading to a relative hypovolemia and a mismatch of blood flow to the cells. Choice B, Cardiogenic shock, is due to the heart's inability to pump effectively. Choice C, Hypovolemic shock, results from a decrease in intravascular volume. Choice D, Septic shock, is caused by a systemic response to infection.

3. A client who is in her second trimester of pregnancy should increase her caloric intake by how many calories during this trimester?

• A. 110 cal/day
• B. 225 cal/day
• C. 340 cal/day
• D. 450 cal/day

Correct answer: C

Rationale: During the second trimester of pregnancy, it is recommended that a client increases their caloric intake by around 340 calories per day to support the growing needs of both the mother and the developing fetus. This additional intake helps ensure the proper nutrition and energy levels required during this crucial stage of pregnancy. Option A (110 cal/day) is too low to meet the increased demands. Option B (225 cal/day) is also below the recommended amount. Option D (450 cal/day) is higher than necessary and could lead to excessive weight gain, which is not ideal during pregnancy.

4. A client with gastroesophageal reflux disease is being taught by a nurse about managing the illness. Which of the following recommendations should the nurse include in the teaching?

• A. Limit fluid intake not related to meals.
• B. Chew on mint leaves to relieve indigestion.
• C. Avoid eating within 3 hours of bedtime.
• D. Season foods with black pepper.

Correct answer: C

Rationale: The correct recommendation for managing gastroesophageal reflux disease is to avoid eating within 3 hours of bedtime. This helps prevent acid reflux by allowing food to digest before lying down. Choices A, B, and D are incorrect. Limiting fluid intake not related to meals is not a standard recommendation for managing GERD. Chewing on mint leaves may worsen symptoms as mint can relax the lower esophageal sphincter, allowing stomach acid to flow back up. Seasoning foods with black pepper does not specifically help manage GERD.

5. What should be recommended to help prevent early childhood caries (ECC) in infants?

• A. Avoid giving the infant nighttime bottles
• B. Have the infant drink pasteurized skim milk
• C. Feed the infant iron-rich foods
• D. Give the infant fruit juice to drink

Correct answer: A

Rationale: The correct answer is 'A: Avoid giving the infant nighttime bottles' because prolonged exposure to sugars in milk during the night can lead to caries. Options 'B: Have the infant drink pasteurized skim milk' and 'D: Give the infant fruit juice to drink' are not recommended as they contain sugars that can cause cavities, especially in infants. Option 'C: Feed the infant iron-rich foods' is incorrect because while a balanced diet is important, iron-rich foods do not directly prevent caries development.

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