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. What happens when Mrs. Guevarra, a nurse, delegates aspects of the client's care to the nurse-aide, an unlicensed staff member?

• A. Mrs. Guevarra makes the assignment to instruct the staff member
• B. Mrs. Guevarra is assigning the responsibility to the aide but not the accountability for those tasks
• C. Mrs. Guevarra does not need to directly supervise or evaluate the aide
• D. Mrs. Guevarra must know how to perform the task being delegated

Correct answer: C

Rationale: The correct answer is C. While it is true that Mrs. Guevarra is delegating tasks to the nurse-aide, she does not necessarily have to directly supervise or evaluate the aide. She still retains the overall accountability for the care of the client, but direct supervision of the aide is not a requirement for delegation. Choice A is incorrect because the primary purpose of delegation is not instruction. Choice B is also incorrect because although Mrs. Guevarra is delegating tasks, she still retains accountability for those tasks. Finally, choice D is incorrect because the ability to perform the task being delegated is not a requirement for the delegator; the delegatee should have the necessary skills and knowledge to perform the delegated tasks.

3. Overweight and obesity often accompany conditions such as _____ that limit mobility or result in short stature, which can lead to feeding difficulties.

• A. Parkinson's disease
• B. muscular dystrophy
• C. Down syndrome
• D. multiple sclerosis

Correct answer: C

Rationale: The correct answer is C, Down syndrome. Down syndrome is often associated with short stature and limited mobility, which can contribute to feeding difficulties and obesity. Parkinson's disease (choice A) primarily affects motor function, but it is not typically associated with short stature. Muscular dystrophy (choice B) primarily impacts muscle strength and does not necessarily lead to short stature. Multiple sclerosis (choice D) is a neurological condition affecting the central nervous system and does not directly cause short stature or feeding difficulties as seen in Down syndrome.

4. Which of the following is a factor that affects Basal Metabolic Rate (BMR)?

• A. Age
• B. Sleep
• C. Fasting/Starvation
• D. All of the above

Correct answer: D

Rationale: All the listed options (Age, Sleep, Fasting/Starvation, Activity Level) are factors that can affect a person's Basal Metabolic Rate (BMR). BMR is the number of calories your body needs to accomplish its most basic (basal) life-sustaining functions. Age can affect BMR as metabolism slows with age. Sleep can influence BMR as metabolism slows during sleep. Fasting or starvation can decrease BMR as the body conserves energy. Activity level can also influence BMR; the more active you are, the higher your BMR, as your body requires more energy for physical activities.

5. 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.

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