Nursing Elites

1. The mechanism behind most CKD in patients without diabetes is mediated by:

• A. enzyme systems
• B. immune systems
• C. catabolic systems
• D. hormonal systems

Correct answer: B

Rationale: In non-diabetic patients, CKD is often mediated by immune system responses. Chronic inflammation triggered by immune system dysfunction can contribute to progressive kidney damage. Therefore, the correct answer is 'immune systems.' Choices A, C, and D are incorrect because CKD in non-diabetic patients is primarily associated with immune system abnormalities rather than enzyme, catabolic, or hormonal systems.

2. A nurse is providing anticipatory guidance to a client who has Phenylketonuria (PKU) and is planning a pregnancy. Which of the following information should the nurse include in the discussion?

• A. Diet sodas should not be consumed more than two or three times a week.
• B. Serum bilirubin should be monitored once or twice a month during pregnancy.
• C. Breastfeeding will not prevent your baby from developing PKU.
• D. A low-protein diet should be followed for three months before conception.

Correct answer: D

Rationale: A low-protein diet should be followed for three months before conception in individuals with PKU who are planning a pregnancy. This diet helps manage PKU by reducing phenylalanine levels, which is crucial for maternal and fetal health. Choices A, B, and C are incorrect. Choice A is not directly related to managing PKU, choice B focuses on a different aspect of care during pregnancy, and choice C is inaccurate as breastfeeding will not prevent a baby from developing PKU.

3. With which of the following should fluoride supplements never be taken?

• A. Water
• B. Juice
• C. Milk
• D. Soda

Correct answer: C

Rationale: Fluoride supplements should never be taken with milk because the fluoride binds with the calcium in the milk, thereby reducing the effectiveness of the fluoride supplement. Other beverages like water, juice, or soda do not share this characteristic as they do not contain the same level of calcium as milk. The rationale behind choosing milk as the correct answer is that it hampers the effectiveness of fluoride supplements, whereas the other choices do not.

4. What is the purpose of a chest tube after a lobectomy procedure, as understood by the nurse?

• A. Prevent mediastinal shift
• B. Promote chest expansion of the remaining lung
• C. Drain fluids and blood accumulated post-operatively
• D. Remove the air in the lungs to promote lung expansion

Correct answer: C

Rationale: After a lobectomy, a chest tube is typically inserted to drain fluids and blood that may have accumulated post-operatively. This tube helps to prevent complications, such as infections or pneumonia, and aids in patient recovery. While a chest tube may aid in preventing a mediastinal shift (Choice A), promoting chest expansion of the remaining lung (Choice B), and removing air in the lungs to promote lung expansion (Choice D), these are not the primary reasons for its use after a lobectomy. Therefore, Choices A, B, and D are incorrect.

5. What is the most important concern immediately after a myocardial infarction?

• A. Reducing cholesterol intake
• B. Allowing cardiac rest for healing
• C. Reducing saturated fat intake
• D. Eating several small meals each day

Correct answer: B

Rationale: Immediately after a myocardial infarction, the primary concern is to allow the heart to rest and heal to prevent further damage. This is why choice B is the correct answer. While choices A, C, and D might be a part of the long-term management plan following a myocardial infarction, they are not the immediate priority. Reducing cholesterol and saturated fat intake, as well as adjusting eating habits can help prevent future heart issues, but do not directly contribute to the immediate recovery post-myocardial infarction.

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