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. How is an ear infection that persists for less than 14 days classified?

• A. Mastoiditis
• B. Chronic Ear Infection
• C. Acute Ear Infection
• D. Otitis Media

Correct answer: C

Rationale: Acute Ear Infection is the correct answer because it typically refers to an infection that is short-lived and often severe, typically lasting less than 14 days. Chronic Ear Infection (Choice B) is incorrect as it refers to an ear infection that lasts for a long time or recurs often, typically more than three months. Mastoiditis (Choice A) is a complication of a middle ear infection and not an ear infection itself. Otitis Media (Choice D) is a general term for inflammation or infection in the middle ear, which can be either acute or chronic, so it's not specific enough to be the correct answer. Understanding the duration and severity of symptoms can help in identifying the type of ear infection, facilitating appropriate treatment and prevention of complications.

3. The priority nursing diagnosis for a client with major depression is:

• A. Altered nutrition
• B. Altered thought process
• C. Self care deficit
• D. Risk for injury

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 can be a potential consequence of consuming insufficient fat?

• A. constipation
• B. marasmus
• C. infertility
• D. diverticulitis

Correct answer: C

Rationale: The correct answer is C. Fat is crucial for the production of hormones, including reproductive hormones. Consuming too little fat can lead to hormonal imbalances, affecting fertility. Choices A, B, and D are incorrect. Constipation is more commonly associated with insufficient fiber intake, marasmus is severe malnutrition due to overall calorie deficiency, and diverticulitis is often related to low fiber intake and not specifically low fat consumption.

5. What stimulates bile secretion from the liver to the small intestine?

• A. Pepsin
• B. Salivary Amylase
• C. CCK
• D. Secretin

Correct answer: C

Rationale: Cholecystokinin (CCK) is the hormone that stimulates the release of bile from the gallbladder into the small intestine, aiding in fat digestion. Pepsin is an enzyme in the stomach that breaks down proteins into smaller peptides, not involved in bile secretion. Salivary Amylase is an enzyme in saliva that initiates starch digestion in the mouth, not related to bile secretion. Secretin is a hormone that regulates the release of gastric juice in the stomach and triggers the pancreas to neutralize stomach acid in the small intestine, but it does not stimulate bile secretion.

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