Nursing Elites

1. 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.

2. Which of the following converts starch to disaccharides, and this reaction occurs in the _____?

• A. pancreatic amylases, small intestine
• B. brush border enzymes, small intestine
• C. luminal enzymes, large intestine
• D. pancreatic amylases, pancreas

Correct answer: A

Rationale: The correct answer is A. Pancreatic amylases break down starch into disaccharides in the small intestine. This process occurs in the small intestine, not the large intestine or pancreas. Brush border enzymes act on disaccharides to break them down into monosaccharides, while luminal enzymes are not specifically involved in the conversion of starch to disaccharides.

3. Which food is a reliable source of B12 for a pregnant vegan client?

• A. Soybeans
• B. Algae
• C. Fortified soy milk
• D. Sea vegetables

Correct answer: C

Rationale: Fortified soy milk is a reliable source of vitamin B12 for pregnant vegan clients as it is usually enriched with this vitamin. The other options, while nutritious, are not reliable sources of B12 for vegans. Soybeans may not provide enough B12, algae contains B12 analogs that the human body cannot utilize, and the B12 content in sea vegetables can fluctuate, potentially not providing the necessary daily intake.

4. A nurse is developing an education program for a community group about dietary intake of vitamins and minerals in the diet. The nurse should include which of the following foods as sources of vitamin C? (Select the food that does not apply.)

• A. Green pepper
• B. Orange
• C. Cabbage
• D. Milk

Correct answer: D

Rationale: The correct answer is E: Milk. Milk is not a significant source of vitamin C. Choices A, B, C, and D are all good sources of vitamin C. Green pepper, orange, cabbage, and strawberries contain vitamin C and can be included in the diet to meet the body's need for this essential vitamin. Milk, on the other hand, is not known for its vitamin C content, so it does not apply as a source of this particular vitamin.

5. Which of the following terms describes the amount of blood ejected per heartbeat?

• A. Stroke volume
• B. Cardiac output
• C. Ejection fraction
• D. Afterload

Correct answer: A

Rationale: The correct answer is A: Stroke volume. Stroke volume refers to the amount of blood ejected by the left ventricle in one contraction. Choice B, Cardiac output, is the total volume of blood pumped by the heart per minute and is calculated by multiplying stroke volume by heart rate. Choice C, Ejection fraction, is the percentage of blood pumped out of the left ventricle with each heartbeat. Choice D, Afterload, refers to the pressure or resistance that the ventricles must overcome to eject blood during systole. Therefore, in the context of the question, the term that specifically describes the amount of blood ejected per heartbeat is stroke volume.

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