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. The nurse is working with a patient who recently had a stroke. The patient frequently chokes and coughs when eating and is having difficulty feeding herself. What is the best way to ensure adequate nutrition?

• A. to have an aide feed her at each meal
• B. to ask a family member to assist during meals
• C. to provide tube feedings for the patient
• D. to initiate TPN for the patient

Correct answer: C

Rationale: The best way to ensure adequate nutrition for a stroke patient who frequently chokes and coughs when eating and has difficulty feeding herself is to provide tube feedings. Tube feedings are a safe and effective method to deliver nutrition directly to the stomach or intestines, bypassing the swallowing mechanism, reducing the risk of aspiration. Having an aide feed her each meal (choice A) may not address the underlying issue of swallowing difficulty and aspiration risk. Asking a family member to be present at each meal (choice B) does not provide a definitive solution to the patient's nutritional needs. Placing the patient on total parenteral nutrition (TPN) (choice D) is a more invasive and typically reserved for patients who cannot tolerate enteral feedings or have non-functional gastrointestinal tracts.

3. Legally, Patients chart are:

• A. Owned by the government since it is a legal document
• B. Owned by the doctor in charge and should be kept from the administrator for whatever reason
• C. Owned by the hospital and should not be given to anyone who request it other than the doctor in charge
• D. Owned by the patient and should be given by the nurse to the client as requested

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. Earliest sign of skin reaction to radiation therapy is:

• A. desquamation
• B. erythema
• C. atrophy
• D. pigmentation

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.

5. Which item is typically fortified with iodine to address iodine deficiency in the population?

• A. Flour
• B. Salt
• C. Canned vegetables
• D. Drinking water

Correct answer: B

Rationale: Iodized salt is the correct answer. Iodine deficiency can lead to thyroid problems, so iodine is added to salt to ensure an adequate intake of this essential nutrient. Flour is often fortified with other nutrients like folic acid, iron, and niacin, but not iodine. Canned vegetables and drinking water are not typically fortified with iodine to address deficiency in the population.

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