Nursing Elites

1. The priority nursing diagnosis for a client with major depression is:

• A. Altered nutrition
• B. Altered thought process
• C. Self care deficit
• D. Risk for injury

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.

2. A client newly diagnosed with hypertension is receiving teaching about the Mediterranean diet from a nurse. Which of the following statements by the client indicates a need for further teaching?

• A. I will limit my intake of red meat to twice weekly.
• B. I can have dairy in moderate portions daily.
• C. I can have fish two times a week.
• D. I can drink wine in moderation.

Correct answer: D

Rationale: The correct answer is D. Patients with hypertension should be advised to limit alcohol consumption, including wine, to help manage their blood pressure. Choices A, B, and C are all consistent with the Mediterranean diet and are appropriate for a client with hypertension. Reducing red meat intake, consuming dairy in moderate portions, and having fish regularly align with the principles of this heart-healthy eating pattern.

3. A client who underwent surgical placement of a colostomy is being cared for by a nurse. Which of the following statements indicates the client understands the dietary teaching?

• A. "Eating yogurt can help decrease the amount of gas that I have."?
• B. "I should eliminate pasta from my diet so that I don't have as many loose stools."?
• C. "My largest meal of the day should be in the evening."?
• D. "Carbonated beverages can help control odor."?

Correct answer: D

Rationale: The correct answer is D. Carbonated beverages can help control odor in clients with colostomies. This is because carbonated drinks can help decrease odor by reducing the production of odoriferous compounds in the colon. Choices A, B, and C are incorrect. Eating yogurt may help regulate bowel movements but does not specifically address odor control associated with colostomies. Eliminating pasta from the diet to reduce loose stools is not necessary for colostomy care. The timing of the largest meal of the day is not directly related to dietary teaching for colostomy care.

4. A healthcare professional has just inserted an NG tube for a client who is to start enteral tube feedings. Which of the following actions should the healthcare professional take to verify tube placement?

• A. Measure the tube length.
• B. Obtain an abdominal x-ray.
• C. Flush the tube with 20 mL of water.
• D. Auscultate the client’s lungs.

Correct answer: B

Rationale: Obtaining an abdominal x-ray is the most accurate method to verify the correct placement of an NG tube. Measuring the tube length is not a reliable method to confirm placement as it may vary among individuals. Flushing the tube with water and auscultating the client's lungs are not definitive methods to ensure proper NG tube placement.

5. Each is a characteristic manifestation of necrotizing ulcerative gingivitis (NUG), except one. Which is the exception?

• A. Gingival erythema
• B. Necrosis of interdental papilla
• C. Marasmus
• D. Metallic taste and foul odor

Correct answer: C

Rationale: The correct answer is C: Marasmus. Marasmus is a form of severe malnutrition and is not a direct manifestation of necrotizing ulcerative gingivitis (NUG). Choices A, B, and D are all characteristic manifestations of NUG. Gingival erythema, necrosis of interdental papilla, and metallic taste with foul odor are commonly associated with NUG due to the inflammatory and necrotic nature of the condition.

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