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 nurse is instructing a group of clients regarding calcium-rich foods. Which of the following foods should the nurse include in the teaching as the best source of calcium?

• A. 1?2 cup ice cream
• B. 1 ounce Swiss cheese
• C. 1 cup milk
• D. 1 cup cottage cheese

Correct answer: D

Rationale: Cottage cheese is the best source of calcium among the options provided. It is rich in calcium and provides a significant amount per serving. 1 cup of cottage cheese contains more calcium compared to 1?2 cup of ice cream, 1 ounce of Swiss cheese, or 1 cup of milk. Ice cream is not a significant source of calcium and is often high in sugar and fat. Swiss cheese and milk contain calcium, but cottage cheese has a higher calcium content per serving, making it the best choice for meeting calcium needs.

3. Which of the following nursing interventions is appropriate after a total thyroidectomy?

• A. Place pillows under your patient’s shoulders.
• B. Raise the knee-gatch to 30 degrees
• C. Keep you patient in a high-fowler’s position.
• D. Support the patient’s head and neck with pillows and sandbags.

Correct answer: D

Rationale: Understanding the underlying pathology and therapeutic techniques ensures that nursing care is not only reactive but also preventative, reducing the risk of complications.

4. A nurse is providing teaching to a group of parents of newborns who are planning to formula feed. Which of the following statements by a parent indicates a need for further teaching?

• A. "I will give formula to my baby at room temperature."
• B. "I will ensure my baby's feeds last 10 to 15 minutes."
• C. "I will burp my baby halfway through each feeding."
• D. "I will watch for signs my baby is full and stop the feeding."

Correct answer: B

Rationale: The correct answer is, "I will ensure my baby's feeds last 10 to 15 minutes." This statement indicates a need for further teaching because it suggests a strict time limit for feedings, which may not be appropriate for a newborn. Newborns should be allowed to feed as long as they want, typically around 20-30 minutes per breast if breastfeeding, or on-demand with formula. Choices A, C, and D demonstrate proper feeding practices such as feeding at room temperature, burping halfway through each feeding, and watching for signs of fullness to stop the feeding, which are all appropriate responses by a parent of a formula-fed newborn.

5. Begins carb digestion in the mouth:

• A. pepsin
• B. salivary amylase
• C. CCK
• D. secretin

Correct answer: B

Rationale: Salivary amylase is the enzyme that begins the digestion of carbohydrates in the mouth by breaking down starches into simpler sugars.

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