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 practice is a type of traditional Chinese medicine?

• A. magnet therapy
• B. acupuncture
• C. faith healing
• D. biofeedback

Correct answer: B

Rationale: Acupuncture is a key practice in traditional Chinese medicine. It involves the insertion of thin needles into specific points on the body to balance energy flow and promote healing. Magnet therapy, faith healing, and biofeedback are not specifically associated with traditional Chinese medicine practices.

3. Diego is undergoing blood transfusion of the first unit. The earliest signs of transfusion reactions are:

• A. Oliguria and jaundice
• B. Urticaria and wheezing
• C. Headache, chills, & fever
• D. Hypertension and flushing

Correct answer: A

Rationale: Patient safety and efficacy of care depend on actions rooted in established nursing protocols that consider both the immediate and long-term needs of the patient.

4. Metabolic control is especially important for women with gestational diabetes to ensure the infant does not develop:

• A. microsomia
• B. macrosomia
• C. type 1 diabetes
• D. type 2 diabetes

Correct answer: B

Rationale: Metabolic control is crucial for women with gestational diabetes to prevent the development of macrosomia, which is characterized by an abnormally large baby. This condition poses risks such as birth injuries and necessitates careful management of blood sugar levels. Microsomia is not a known term related to this context. Type 1 and type 2 diabetes are not conditions the infant would develop as a result of gestational diabetes in the mother.

5. Each of the following accurately describes aspects of the dietary reference intakes (DRIs) published by the Food and Nutrition Board of the Institute of Medicine (IOM) except one. Which one is the exception?

• A. The DRIs replace the older recommended daily allowances
• B. Current DRIs attempt to estimate required nutrients to improve long-term health
• C. DRIs specifically address individuals whose requirements are affected by a disease state
• D. The DRIs attempt to establish maximum safe levels of tolerance for nutrients

Correct answer: C

Rationale: The correct answer is C. DRIs are intended for the general population and do not specifically address disease states, which are managed with different clinical guidelines. Choice A is correct as DRIs have replaced the older recommended daily allowances. Choice B is correct as current DRIs aim to estimate the required nutrients for long-term health. Choice D is correct as DRIs also attempt to establish maximum safe levels of tolerance for nutrients.

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