Nursing Elites

1. What is the purpose of the cuff in a Tracheostomy tube?

• A. Separate the upper and lower airway
• B. Separate trachea from the esophagus
• C. Separate the larynx from the nasopharynx
• D. Secure the placement of the tube

Correct answer: B

Rationale: The purpose of the cuff in a Tracheostomy tube is to separate the trachea from the esophagus. The cuff helps prevent aspiration by creating a seal that separates the trachea from the esophagus, reducing the risk of food or fluids entering the lungs. Choices A, C, and D are incorrect because the cuff's primary function in a Tracheostomy tube is to prevent aspiration rather than separating the upper and lower airway, larynx from the nasopharynx, or securing the placement of the tube.

2. What is the procedure called when direct observations are used to generate an estimate of a client's current food intake?

• A. Food diary
• B. 24-hour recall
• C. Kilocalorie count
• D. Nutrient surveillance record

Correct answer: C

Rationale: A kilocalorie count is the correct answer as it involves directly observing a client's food intake, which is often used in hospitals to accurately assess nutritional intake and ensure it meets dietary requirements. A food diary (Choice A) is typically self-reported by the client and not directly observed. A 24-hour recall (Choice B) is also usually self-reported and relies on a client's memory of the past 24 hours, which can be unreliable. A nutrient surveillance record (Choice D) is a broader term for tracking nutrient intake in a population and is not specific to the direct observation of an individual's food intake.

3. What describes a criterion used to diagnose diabetes?

• A. a plasma glucose concentration of 100 mg/dL or higher after a fast of at least 12 hours
• B. a casual blood sample of 200 mg/dL or higher in a person with classic symptoms
• C. a plasma glucose concentration measured two hours after a 200-gram glucose load is 400 mg/dL or higher
• D. a HbA1C higher than 5 percent

Correct answer: B

Rationale: A casual blood sample of 200 mg/dL or higher in a person with classic symptoms is a diagnostic criterion for diabetes. This choice aligns with the typical clinical presentation of diabetes and is a key diagnostic indicator. Choices A, C, and D do not accurately reflect the established criteria for diagnosing diabetes, making them incorrect. Choice A pertains to a fasting plasma glucose level, Choice C involves a glucose challenge test, and Choice D refers to HbA1C levels, which are used for monitoring blood sugar control over time, not for diagnosing diabetes.

4. You are an ostomy nurse and you know that colostomy is defined as:

• A. It is an incision into the colon to create an artificial opening to the exterior of the abdomen
• B. It is end to end anastomosis of the gastric stump to the duodenum
• C. It is end to end anastomosis of the gastric stump to the jejunum
• D. It is an incision into the ileum to create an artificial opening to the exterior of the abdomen

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.

5. In an extreme situation and when no other resident or intern is available, should a nurse receive telephone orders, the order has to be correctly written and signed by the physician within:

• A. 24 hours
• B. 36 hours
• C. 48 hours
• D. 12 hours

Correct answer: B

Rationale: In an extreme situation where no other resident or intern is available, if a nurse receives telephone orders, the order has to be correctly written and signed by the physician within 36 hours. This time frame ensures timely documentation and validation of the orders. Choice A (24 hours) is too short a period for busy physicians to fulfill the task. Choice C (48 hours) is too long and delays the incorporation of physician orders into the patient's care plan. Choice D (12 hours) may not provide enough time for the physician to review and sign the order, especially in situations where immediate attention is not required.

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