Nursing Elites

1. The recommended daily fluid intake of patients maintained using hemodialysis is:

• A. 150 mL plus the volume of urinary output
• B. 500 mL plus the volume of urinary output
• C. 1000 mL plus the volume of urinary output
• D. 1500 mL plus the volume of urinary output

Correct answer: C

Rationale: The correct answer is C: 1000 mL plus the volume of urinary output. Fluid intake is typically restricted in hemodialysis patients to prevent fluid overload. The recommended daily fluid intake for these patients is 1000 mL plus any urinary output. Choice A (150 mL plus the volume of urinary output) is too low and would not provide enough fluid for these patients. Choice B (500 mL plus the volume of urinary output) is also insufficient. Choice D (1500 mL plus the volume of urinary output) is too high and may lead to fluid overload in hemodialysis patients.

2. A client states they are taking greater than the recommended daily allowance of vitamin E to prevent cataracts. Which complication should the nurse educate the client as related to taking excessive amounts of vitamin E?

• A. Lung cancer
• B. Stroke
• C. Diarrhea
• D. Liver damage

Correct answer: B

Rationale: The correct answer is B: Stroke. High doses of vitamin E supplements have been associated with an increased risk of hemorrhagic stroke due to its blood-thinning properties. Option A, lung cancer, is not a known complication of excessive vitamin E intake. Option C, diarrhea, is more commonly associated with excessive intake of other vitamins or minerals. Option D, liver damage, is not a commonly reported complication of vitamin E overdose.

3. What goal should an overweight woman include in her lifestyle for a healthy pregnancy?

• A. Aim to lose 11 to 20 pounds during pregnancy
• B. Increase protein intake to 35% of total calories
• C. Delay weight loss until after pregnancy
• D. Increase daily energy intake by 550 calories

Correct answer: C

Rationale: The healthiest approach for an overweight pregnant woman is to delay weight loss until after pregnancy. During pregnancy, the body needs sufficient nutrition and energy to support the growth and development of the baby. Attempting to lose weight during pregnancy, especially significant amounts, may compromise the health of both the mother and the baby. Increasing protein intake to 35% of total calories or energy intake by 550 calories per day without professional guidance may lead to an unbalanced diet, which is not optimal for pregnancy. The focus should be on maintaining a balanced, nutrient-rich diet and appropriate weight gain during pregnancy.

4. You are on duty in the medical ward. You were asked to check the narcotics cabinet. You found out that what is on record does not tally with the drugs used. What will you do first?

• A. Write an incident report and refer the matter to the nursing director
• B. Keep your findings to yourself
• C. Report the matter to your supervisor
• D. Find out from the endorsement any patient who might have been given narcotics

Correct answer: C

Rationale: In this situation, the first step should be to report the matter to your supervisor. It is essential to notify the appropriate authority immediately to address the discrepancy in the narcotics cabinet. Choice A is not the first step as reporting to the nursing director should follow after informing the supervisor. Keeping the findings to yourself (Choice B) is not appropriate as it may jeopardize patient safety and is against ethical standards. While finding out which patient received narcotics (Choice D) is important, it is not the immediate action to take in this scenario.

5. A nurse is providing teaching about food allergies to the parents of a toddler. Which of the following foods should the nurse identify as highest risk for allergies in toddlers?

• A. Eggs
• B. Milk
• C. Bananas
• D. Citrus fruits

Correct answer: A

Rationale: The correct answer is A: Eggs. Eggs are one of the most common food allergens in toddlers and should be introduced carefully. Milk (choice B) is also a common allergen but is typically introduced earlier in a child's diet. Bananas (choice C) and citrus fruits (choice D) are less likely to cause allergic reactions compared to eggs.

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