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 reports having difficulty losing weight. Which of the following responses by the nurse is appropriate?

• A. Eat small portions of high-calorie foods first.
• B. Set a goal, and you will be able to attain it.
• C. It is helpful to self-monitor your eating.
• D. Taste food while cooking to help curb your appetite.

Correct answer: C

Rationale: The correct answer is C: 'It is helpful to self-monitor your eating.' Self-monitoring dietary intake is an evidence-based strategy that enhances awareness and accountability, making it an effective approach for weight management. Choice A is incorrect as focusing on high-calorie foods first may not be the most effective strategy for weight loss. Choice B is too general and lacks actionable advice. Choice D, tasting food while cooking, does not directly address the client's difficulty in losing weight and is not a proven method for weight management.

3. Fires are approached using the mnemonic RACE, in which, R stands for:

• A. Run
• B. Race
• C. Rescue
• D. Remove

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. What physiologic role does magnesium play in the body?

• A. Blood clotting, transmission of nerve impulses, muscle contraction and relaxation
• B. Calcium homeostasis, structural integrity of heart muscle
• C. No known metabolic function, caries-preventing properties
• D. ATP energy release; metabolism of fats, carbohydrates, proteins; regulates acid-base balance

Correct answer: B

Rationale: The correct answer is B. Magnesium plays an important role in maintaining calcium homeostasis and preventing skeletal abnormalities. It is involved in more than 300 enzymatic reactions, including energy metabolism, insulin activity, and glucose use. Magnesium is vital to the structural integrity of heart muscle and other muscles and nerves. While magnesium does play a role in blood clotting, nerve impulses, muscle contraction, relaxation, ATP energy release, and metabolism of fats, carbohydrates, proteins, the primary physiologic role of magnesium in the body is related to calcium homeostasis and maintaining the structural integrity of the heart muscle. Choice A is incorrect because it includes functions of magnesium, but they are not its primary physiologic role. Choice C is incorrect as magnesium has several known metabolic functions. Choice D is incorrect because although magnesium is involved in ATP energy release and metabolism, its primary role is related to calcium homeostasis and structural integrity of muscle.

5. A healthcare professional is reviewing the lab results of a client who has bulimia nervosa. The professional should notify the provider of which of the following results?

• A. White Blood Cells 5,200/mm³
• B. Hemoglobin 14 g/dL
• C. Magnesium 1.6 mg/dL
• D. Potassium 3.2 mEq/L

Correct answer: D

Rationale: A potassium level of 3.2 mEq/L is below normal and requires provider notification, especially in clients with bulimia nervosa who are at risk of electrolyte imbalances. Low potassium levels can lead to serious complications like cardiac arrhythmias. The other options are within or close to the normal range and would not be a priority for notification.

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