Nursing Elites

1. You are an ostomy nurse and you know that colostomy is defined as:

• A. It is an incision into the colon to create an artificial opening to the exterior of the abdomen
• B. It is end to end anastomosis of the gastric stump to the duodenum
• C. It is end to end anastomosis of the gastric stump to the jejunum
• D. It is an incision into the ileum to create an artificial opening to the exterior of the abdomen

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.

2. A nurse is instructing a group of clients about nutrition. The nurse should include that which of the following is a trigger for the formation of vitamin D in the body?

• A. Calcium
• B. Vitamin A depletion
• C. Exposure to sunlight
• D. Weight-bearing exercise

Correct answer: C

Rationale: Exposure to sunlight is the trigger for the formation of vitamin D in the body. When the skin is exposed to sunlight, it produces vitamin D. This process is essential for maintaining healthy levels of vitamin D in the body. Calcium (Choice A) is important for bone health but is not the trigger for vitamin D formation. Vitamin A depletion (Choice B) does not directly trigger the formation of vitamin D. Weight-bearing exercise (Choice D) is crucial for bone health but is not directly related to the formation of vitamin D.

3. A nurse is providing teaching to a client who has type 1 diabetes mellitus. Which of the following statements by the client indicates an understanding of the teaching?

• A. Albumin in my urine is an indication of normal kidney function.
• B. I will keep my HbA1c at five percent.
• C. I will have ketones in my urine if my blood glucose is maintained at 190 milligrams per deciliter.
• D. I will keep my blood glucose levels between 200 and 212 milligrams per deciliter.

Correct answer: B

Rationale: The correct answer is B. Maintaining an HbA1c level of 5 percent indicates good long-term blood glucose control and understanding of diabetes management. Choice A is incorrect because the presence of albumin in the urine (albuminuria) is actually an indication of kidney damage in diabetes. Choice C is incorrect as ketones in the urine are a sign of inadequate insulin and can occur when blood glucose levels are high, not at a specific level like 190 mg/dL. Choice D is also incorrect as the client should aim to keep blood glucose levels within a tighter range for better control, typically between 80-130 mg/dL before meals and less than 180 mg/dL after meals.

4. What is the best snack choice for a preschool-age child?

• A. Fruit snacks
• B. Mini wheat bagel with peanut butter
• C. White toast with jelly
• D. Sports drink

Correct answer: B

Rationale: The best snack choice for a preschool-age child is a mini wheat bagel with peanut butter as it provides a good balance of carbohydrates, protein, and healthy fats. Fruit snacks, although they contain some fruit flavor, are often high in added sugars and lack essential nutrients. White toast with jelly may provide quick energy but lacks protein and healthy fats, which are important for a balanced snack choice. Sports drinks are typically high in sugar and unnecessary for a preschool-age child's snack, as they are designed for rehydration during intense physical activity, not as a regular snack option.

5. Clients may benefit from slightly higher fat intakes than are normally recommended if they have:

• A. congestive heart failure
• B. cerebrovascular accident
• C. peripheral vascular disease
• D. chronic obstructive pulmonary disease

Correct answer: D

Rationale: In chronic obstructive pulmonary disease (COPD), higher fat intake can be beneficial because it provides more calories with less respiratory burden compared to carbohydrates. Choices A, B, and C are incorrect because congestive heart failure, cerebrovascular accident, and peripheral vascular disease do not specifically benefit from higher fat intakes as in COPD.

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