Nursing Elites

1. Which of the following best describes Primary Nursing?

• A. Assigning a nurse to lead a team of registered nurses in the care of a patient from admission to discharge
• B. Assigning a nurse to perform administrative tasks in a healthcare setting
• C. Assigning a nurse to provide medical treatment without supervision
• D. Assigning a nurse to be the main caregiver responsible for coordinating all aspects of care for a group of patients

Correct answer: A

Rationale: Primary Nursing involves assigning a dedicated nurse to lead a team of registered nurses in the care of a patient from admission to discharge. This approach ensures continuity and personalized care. Choices B and C are incorrect as they do not accurately describe Primary Nursing. Choice D is incorrect as it refers to a different care delivery model.

2. Medication for treating high blood cholesterol levels should not be used for most people unless:

• A. The patient has at least three major risk factors for coronary heart disease
• B. The patient has been experiencing symptoms of coronary heart disease for at least three months
• C. The patient's medical insurance covers prescription drugs
• D. Treatment with Therapeutic Lifestyle Changes (TLC) alone is unsuccessful after three months

Correct answer: D

Rationale: The correct answer is choice D because medication for high cholesterol is typically not considered unless Therapeutic Lifestyle Changes (TLC), which include diet and exercise, have not proven effective after a three-month period. This approach ensures that lifestyle modifications are given a fair chance to lower cholesterol levels before resorting to medication. Choice A is incorrect because the number of risk factors for coronary heart disease does not dictate when to begin medication; it is about the effectiveness of lifestyle changes. Choice B is incorrect as the duration of coronary heart disease symptoms does not determine when to start medication; the focus is on the response to TLC. Choice C is incorrect because the coverage of prescription drugs by the patient's insurance does not influence the medical decision to use medication for high cholesterol; it is based on medical necessity and effectiveness of prior interventions.

3. A client at risk for iron-deficiency anemia is being taught by a nurse about optimizing dietary intake of iron. The nurse should explain that which of the following sources of iron is easiest for the body to absorb?

• A. Spinach
• B. Cantaloupe
• C. Chicken
• D. Lentils

Correct answer: C

Rationale: The correct answer is 'Chicken.' Chicken contains heme iron, which is more easily absorbed by the body compared to non-heme iron found in plant-based sources like spinach, cantaloupe, and lentils. Heme iron, as present in chicken, is more bioavailable and is better absorbed by the body, making it an excellent source of iron for individuals at risk of iron-deficiency anemia. Spinach, cantaloupe, and lentils contain non-heme iron, which is not as efficiently absorbed as heme iron.

4. The nurse is working with a patient who recently had a stroke. The patient frequently chokes and coughs when eating and is having difficulty feeding herself. What is the best way to ensure adequate nutrition?

• A. to have an aide feed her at each meal
• B. to ask a family member to assist during meals
• C. to provide tube feedings for the patient
• D. to initiate TPN for the patient

Correct answer: C

Rationale: The best way to ensure adequate nutrition for a stroke patient who frequently chokes and coughs when eating and has difficulty feeding herself is to provide tube feedings. Tube feedings are a safe and effective method to deliver nutrition directly to the stomach or intestines, bypassing the swallowing mechanism, reducing the risk of aspiration. Having an aide feed her each meal (choice A) may not address the underlying issue of swallowing difficulty and aspiration risk. Asking a family member to be present at each meal (choice B) does not provide a definitive solution to the patient's nutritional needs. Placing the patient on total parenteral nutrition (TPN) (choice D) is a more invasive and typically reserved for patients who cannot tolerate enteral feedings or have non-functional gastrointestinal tracts.

5. A client with a large lower-leg ulcer needs protein for wound healing. Which of the following foods should the nurse suggest?

• A. Kidney beans
• B. Grilled salmon
• C. Peanut butter
• D. Raw spinach

Correct answer: B

Rationale: Grilled salmon is the best choice for providing high-quality protein for wound healing. Salmon is rich in essential amino acids, omega-3 fatty acids, and vitamin D, which can help promote tissue repair and reduce inflammation. Kidney beans, peanut butter, and raw spinach are good protein sources but do not offer the same level of high-quality protein and nutrients needed specifically for wound healing.

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