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 with nephropathy secondary to diabetes mellitus is receiving dietary teaching from a nurse and plans to make dietary adjustments. Which of the following instructions should the nurse include?

• A. Consume less than 45% of total calories from carbohydrates per day.
• B. Eat no more than 300 mg of cholesterol per day.
• C. Consume less than 0.8 g/kg of body weight of protein per day.
• D. Eat at least 45 g of fiber per day.

Correct answer: D

Rationale: For a client with nephropathy secondary to diabetes mellitus, increasing fiber intake is essential as it can help manage blood sugar levels and improve overall bowel health. Choice A is incorrect because carbohydrates should be controlled but not limited to less than 45% of total calories. Choice B is incorrect as the recommended daily cholesterol intake for individuals with diabetes is less than 200 mg. Choice C is incorrect as protein intake should be individualized based on the client's condition and should not be limited to less than 0.8 g/kg of body weight per day.

3. What is the primary purpose of dietary fiber in the diet?

• A. Improving digestion
• B. Providing energy
• C. Aiding in the absorption of vitamins
• D. Reducing cholesterol

Correct answer: D

Rationale: The primary purpose of dietary fiber in the diet is to reduce cholesterol levels. While it does aid in digestion by promoting regular bowel movements, its main role is in lowering cholesterol. Choice A is partially correct but not the primary purpose. Choice B is incorrect as fiber is not a direct source of energy. Choice C is also incorrect as the primary role of fiber is not in the absorption of vitamins.

4. Which of the following best represents the goal of reflective listening?

• A. Repeating what the patient says
• B. Informing using direct advice
• C. Keeping the patient talking
• D. Warning the patient

Correct answer: C

Rationale: The correct answer is C. The goal of reflective listening is to keep the patient talking, allowing them to express their thoughts and concerns fully. Choice A, 'Repeating what the patient says,' is incorrect as reflective listening involves paraphrasing or summarizing rather than verbatim repetition. Choice B, 'Informing using direct advice,' is incorrect because reflective listening focuses on understanding the patient's perspective rather than providing direct advice. Choice D, 'Warning the patient,' is also incorrect as reflective listening aims to create a safe and open environment for the patient to share without feeling judged or warned.

5. Which strategy would most likely help alleviate some of the nausea that a 10-week pregnant woman experiences every morning, preventing her from eating breakfast?

• A. Increase intake of dairy products, including yogurt and ice cream
• B. Maintain an upright position while eating
• C. Opt for foods that are high in fiber
• D. Consume small, frequent meals when hunger strikes

Correct answer: D

Rationale: The correct answer is D, 'Consume small, frequent meals when hunger strikes.' This strategy is ideal for managing morning sickness because it prevents the stomach from becoming too empty, which can exacerbate nausea. Option A may not be helpful because dairy products can sometimes worsen nausea. Option B is not the most effective solution as the sitting position does not directly impact nausea levels. Option C, while generally beneficial for digestion and overall health, does not specifically address the issue of pregnancy-related nausea.

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