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. 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.

3. When carbohydrates are eliminated from the diet to lose weight, which nutrients are most likely to become insufficient?

• A. Iron, fiber, and protein
• B. Iron, fiber, and vitamin K
• C. Vitamin A and vitamin C
• D. Iron, fiber, and B vitamins

Correct answer: D

Rationale: Iron, fiber, and B vitamins are most likely to become insufficient when carbohydrates are eliminated from the diet to lose weight. Carbohydrates are a primary source of B vitamins and fiber in the diet. Iron can also be obtained from plant-based sources like legumes and whole grains, which are often eliminated when carbohydrates are restricted. Choices A, B, and C are incorrect because protein, vitamin K, vitamin A, and vitamin C are not primarily sourced from carbohydrates and are less likely to become insufficient solely due to carbohydrate elimination.

4. Which lipid contains 3 fatty acids?

• A. cholesterol
• B. phospholipid
• C. saturated
• D. triglyceride

Correct answer: D

Rationale: The correct answer is 'D. triglyceride.' Triglycerides are composed of one glycerol molecule and three fatty acids, making them the primary form of stored fat in the body. Cholesterol (A) is a different type of lipid, phospholipids (B) have two fatty acids, and 'saturated' (C) refers to the structure of fatty acids, not a specific lipid containing 3 fatty acids.

5. What instruction should a nurse include when teaching a client who has recently been prescribed a low-sodium diet?

• A. Avoid foods such as smoked meats and frozen dinners.
• B. Select foods with less than 4g of sodium as indicated on food labels.
• C. Use soy sauce for flavoring foods instead of table salt.
• D. Processed and prepared foods are typically low in sodium.

Correct answer: A

Rationale: The correct answer is A, which directs the client to avoid foods such as smoked meats and frozen dinners. These types of foods are typically high in sodium, making them unsuitable for a low-sodium diet. Option B is incorrect because foods with less than 4g of sodium might still be high in sodium for individuals on low-sodium diets. The daily recommended intake of sodium for a low-sodium diet is usually around 1.5g to 2g. Hence, 4g of sodium in a single food product can be excessive. Option C is incorrect as soy sauce, although a different source of flavor, is also high in sodium and should be used sparingly, if at all, in a low-sodium diet. Option D is incorrect because processed and prepared foods are usually not low in sodium. In fact, these foods often have high sodium content due to added salts and preservatives.

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