Nursing Elites

1. What is the initial major sign of acute renal failure?

• A. Oliguria
• B. Hematuria
• C. Proteinuria
• D. Glycosuria

Correct answer: A

Rationale: Oliguria, or reduced urine output, is often the initial major sign of acute renal failure. This reduction in urine output indicates that the kidneys are not functioning properly. Hematuria (blood in urine), proteinuria (presence of protein in urine), and glycosuria (presence of glucose in urine) are not typically the initial major signs of acute renal failure. While they may be present in certain conditions, oliguria is the most common and critical indicator of acute renal failure.

2. In a therapeutic relationship, the nurse must understand own values, beliefs, feelings, prejudices & how these affect others. This is called:

• A. Therapeutic use of self
• B. Psychotherapy
• C. Therapeutic communication
• D. Self awareness

Correct answer: A

Rationale: Patient safety and efficacy of care depend on actions rooted in established nursing protocols that consider both the immediate and long-term needs of the patient.

3. A nurse is caring for a client who is to receive a mechanically altered diet. Which of the following client food choices necessitates intervention by the nurse?

• A. Scrambled eggs
• B. Cottage cheese
• C. Piece of wheat toast
• D. Sliced banana

Correct answer: D

Rationale: The correct answer is 'Sliced banana.' A mechanically altered diet is designed for clients who have difficulty chewing or swallowing. Sliced bananas, due to their texture and potential choking hazard for clients with swallowing difficulties, would necessitate intervention by the nurse. Scrambled eggs, cottage cheese, and a piece of wheat toast are softer and safer options for clients on a mechanically altered diet, making them appropriate choices.

4. For a patient on a ketogenic diet, which macronutrient is primarily increased?

• A. Carbohydrates
• B. Protein
• C. Fats
• D. Fiber

Correct answer: C

Rationale: The correct answer is C: Fats. A ketogenic diet is characterized by high fat intake, moderate protein intake, and very low carbohydrate intake. This diet aims to shift the body's metabolism to use fat as the primary source of energy instead of carbohydrates. Increasing fat intake while reducing carbohydrates is essential for achieving and maintaining a state of ketosis. Therefore, choices A, B, and D are incorrect as they do not align with the macronutrient adjustments required for a ketogenic diet.

5. Which condition is most closely associated with a high rate of gastroesophageal reflux disease?

• A. Pregnancy
• B. Anorexia
• C. Hypertension
• D. Diabetes mellitus

Correct answer: A

Rationale: Pregnancy is the correct answer as it is most closely associated with a high rate of gastroesophageal reflux disease (GERD). During pregnancy, the growing fetus exerts pressure on the stomach, leading to the backflow of stomach acid into the esophagus, causing GERD. This physiological change is a common occurrence in pregnant individuals. Conversely, anorexia, hypertension, and diabetes mellitus are not typically linked to a high rate of GERD. While these conditions have their own effects on the body, they do not directly contribute to the mechanisms that cause GERD, unlike the physical changes associated with pregnancy. Therefore, choices B, C, and D are incorrect.

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