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. Which foods are the biggest contributors of saturated fats consumed by Americans?

• A. Butter, coconut, and palm oils
• B. Corn oil
• C. Meat and milk
• D. Cheese, pizza, desserts, and chicken

Correct answer: D

Rationale: The correct answer is D: Cheese, pizza, desserts, and chicken. These foods are significant contributors to the intake of saturated fats in the American diet, often found in processed and fast foods. Choices A, B, and C are incorrect because while butter, coconut, and palm oils (A) are sources of saturated fats, they are not the biggest contributors in the American diet. Corn oil (B) is a source of unsaturated fats, and meat and milk (C) contain saturated fats but are not the primary contributors compared to cheese, pizza, desserts, and chicken.

3. A nurse is caring for a client following a CVA and observes the client experiencing severe dysphagia. The nurse notifies the provider. Which of the following nutritional therapies will likely be prescribed?

• A. NPO until dysphagia subsides
• B. Supplements via nasogastric tube
• C. Initiation of total parenteral nutrition
• D. Soft residue diet

Correct answer: B

Rationale: In the scenario of severe dysphagia following a CVA, the client may have difficulty swallowing and require alternative nutritional support. Providing supplements via a nasogastric tube allows for the delivery of essential nutrients directly into the stomach, bypassing the swallowing difficulties. NPO (nothing by mouth) until dysphagia subsides may be too restrictive for the client's nutritional needs. Initiation of total parenteral nutrition is usually reserved for cases where enteral feeding is not possible or contraindicated. A soft residue diet may not be suitable for a client experiencing severe dysphagia.

4. Which gluten-free food choice would be most appropriate for a patient with celiac disease?

• A. Scalloped potatoes
• B. Oatmeal
• C. Eggs
• D. Tortillas

Correct answer: C

Rationale: Eggs are a safe food choice for individuals with celiac disease as they are naturally gluten-free. Scalloped potatoes often contain flour in the sauce, which might contain gluten. Oatmeal can be a subject of debate due to possible cross-contamination during processing, so it might not be safe unless labeled gluten-free. Tortillas are typically made from wheat flour containing gluten, but gluten-free versions are available. However, eggs are universally gluten-free, making them the best choice for individuals with celiac disease.

5. Based on the Code of Ethics for Filipino Nurses, what is regarded as the hallmark of nursing responsibility and accountability?

• A. Human rights of clients, regardless of creed and gender
• B. The privilege of being a registered professional nurses
• C. Health, being a fundamental right of every individual
• D. Accurate documentation of actions and outcomes

Correct answer: B

Rationale: Nursing interventions should be grounded in a deep understanding of the physiological processes involved, ensuring that care provided is both effective and efficient.

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