Nursing Elites

1. What happens when Mrs. Guevarra, a nurse, delegates aspects of the client's care to the nurse-aide, an unlicensed staff member?

• A. Mrs. Guevarra makes the assignment to instruct the staff member
• B. Mrs. Guevarra is assigning the responsibility to the aide but not the accountability for those tasks
• C. Mrs. Guevarra does not need to directly supervise or evaluate the aide
• D. Mrs. Guevarra must know how to perform the task being delegated

Correct answer: C

Rationale: The correct answer is C. While it is true that Mrs. Guevarra is delegating tasks to the nurse-aide, she does not necessarily have to directly supervise or evaluate the aide. She still retains the overall accountability for the care of the client, but direct supervision of the aide is not a requirement for delegation. Choice A is incorrect because the primary purpose of delegation is not instruction. Choice B is also incorrect because although Mrs. Guevarra is delegating tasks, she still retains accountability for those tasks. Finally, choice D is incorrect because the ability to perform the task being delegated is not a requirement for the delegator; the delegatee should have the necessary skills and knowledge to perform the delegated tasks.

2. Which of the following actions would be of highest priority with regards to the external shunt?

• A. Avoid taking blood pressure or blood sample from the arm with the shunt
• B. Instruct the patient not to exercise the arm with the shunt
• C. Heparinize the shunt daily
• D. Change the dressing of the shunt daily

Correct answer: C

Rationale: Heparinizing the shunt daily (choice C) is the highest priority action as it prevents the formation of blood clots that can occlude the shunt, leading to potential complications such as thrombosis. Avoiding taking blood pressure or blood samples from the arm with the shunt (choice A) is also important, but secondary to heparinizing the shunt. Similarly, instructing the patient not to exercise the arm with the shunt (choice B) can help prevent unnecessary strain on the shunt, but it is not as critical as preventing clot formation. Changing the dressing of the shunt daily (choice D) is a standard nursing care practice to prevent infection, but again, it is not as critical as ensuring the shunt remains patent through daily heparinization.

3. A client was rushed in the E.R showing a whitish, leathery and painless burned area on his skin. The nurse is correct in classifying this burn as:

• A. First degree burn C. Third degree burn
• B. Second degree burn D. Partial thickness burn
• C.
• D.

Correct answer: B

Rationale: Nursing interventions should be grounded in a deep understanding of the physiological processes involved, ensuring that care provided is both effective and efficient.

4. Which of the following foods provides the most protein?

• A. Beans
• B. Red peppers
• C. Asparagus
• D. Celery

Correct answer: A

Rationale: The correct answer is A, Beans. Beans are known to be a good source of protein compared to the other options provided. While red peppers, asparagus, and celery are nutritious vegetables, they do not contain as much protein as beans do. Red peppers are high in vitamin C, asparagus is rich in vitamins and minerals, and celery is low in calories and a good source of fiber, but they are not significant sources of protein.

5. Which animal-derived food contains the most significant level of carbohydrates?

• A. Egg
• B. Beef
• C. Milk
• D. Poultry

Correct answer: C

Rationale: Milk contains the most significant level of carbohydrates among animal-derived foods. Milk and milk products supply significant quantities of carbohydrate in the form of lactose. Eggs, beef, and poultry are not significant sources of carbohydrates compared to milk. In cheese making, lactose is removed as a by-product, reducing the carbohydrate content further.

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