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. Most nurses regard this conventional recording of the date, time, and mode by which the patient leaves a healthcare unit but this record includes importantly, directs of planning for discharge that starts soon after the person is admitted to a healthcare institution. It is accepted that collaboration or multidisciplinary involvement (of all members of the health team) in discharge results in comprehensive care. What do you call this?

• A. Discharge Summary
• B. Nursing Kardex
• C. Medicine and Treatment Record
• D. Nursing Health History and Assessment Worksheet

Correct answer: C

Rationale: Effective nursing care involves comprehensive assessments that address all aspects of a patient's condition, ensuring that interventions are appropriately targeted and outcomes are optimized.

3. A nurse is providing teaching to the parent of a toddler about appropriate snacks. Which of the following foods should the nurse include?

• A. Sliced bananas
• B. Raw celery
• C. Peanut butter
• D. Grapes

Correct answer: A

Rationale: The correct answer is sliced bananas. Bananas are a good choice for toddlers as they are easy to chew, rich in potassium, and generally well-tolerated. Raw celery (Choice B) may pose a choking hazard due to its fibrous nature. Peanut butter (Choice C) should be avoided as it can also be a choking hazard and may cause an allergic reaction in some children. Grapes (Choice D) are a choking hazard for toddlers due to their size and shape, so they should be cut into smaller pieces or avoided altogether.

4. A client is receiving education from a nurse regarding the dietary changes needed for weight loss. Which of the following actions should the nurse perform first?

• A. Educate the client about daily caloric requirements.
• B. Determine the client’s daily caloric intake.
• C. Provide the client with meal planning information.
• D. Show the client how to identify the fat content of packaged foods.

Correct answer: B

Rationale: The correct answer is to determine the client’s daily caloric intake first. This step is crucial in understanding the client's current dietary habits and establishing a baseline for creating an effective weight loss plan. Educating the client about daily caloric requirements (Choice A) can only be done effectively after knowing the client's current intake. Providing meal planning information (Choice C) and teaching the client how to identify fat content in foods (Choice D) come after determining the baseline caloric intake to tailor the plan accordingly.

5. What are the manifestations of nephrotic syndrome?

• A. Dehydration
• B. Uremia
• C. Infection
• D. Low blood lipids

Correct answer: C

Rationale: Infection is a common manifestation of nephrotic syndrome. This is due to the loss of immunoglobulins in the urine, which weakens the body's immune defenses. Dehydration (Choice A) and uremia (Choice B) can be symptoms of kidney dysfunction but are not specific manifestations of nephrotic syndrome. Low blood lipids (Choice D) is incorrect as nephrotic syndrome typically results in high, not low, blood lipid levels due to the body's attempt to replace lost proteins.

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