Nursing Elites

1. You are on duty in the medical ward. You were asked to check the narcotics cabinet. You found out that what is on record does not tally with the drugs used. What will you do first?

• A. Write an incident report and refer the matter to the nursing director
• B. Keep your findings to yourself
• C. Report the matter to your supervisor
• D. Find out from the endorsement any patient who might have been given narcotics

Correct answer: C

Rationale: In this situation, the first step should be to report the matter to your supervisor. It is essential to notify the appropriate authority immediately to address the discrepancy in the narcotics cabinet. Choice A is not the first step as reporting to the nursing director should follow after informing the supervisor. Keeping the findings to yourself (Choice B) is not appropriate as it may jeopardize patient safety and is against ethical standards. While finding out which patient received narcotics (Choice D) is important, it is not the immediate action to take in this scenario.

2. Which is NOT a prudent recommendation for a menopausal patient?

• A. Supplement calcium and vitamin D slightly beyond upper intake level
• B. Encourage lean protein and regular exercise
• C. Avoid alcohol if xerostomia is present
• D. Consumption of 90 mg daily of isoflavones in soy products helps to increase bone mass

Correct answer: A

Rationale: Excessive supplementation of calcium and vitamin D beyond the upper intake level is not recommended unless under medical supervision, as it can cause adverse health effects.

3. A patient with an ileostomy is suffering from frequent diarrhea. The clinician should advise the patient to increase his intake of what food to thicken stool output?

• A. celery
• B. salad greens
• C. potatoes
• D. dried beans and peas

Correct answer: C

Rationale: Potatoes are starchy and can help thicken stool output, making them beneficial for patients with an ileostomy experiencing diarrhea.

4. Each of the following accurately describes aspects of the dietary reference intakes (DRIs) published by the Food and Nutrition Board of the Institute of Medicine (IOM) except one. Which one is the exception?

• A. The DRIs replace the older recommended daily allowances
• B. Current DRIs attempt to estimate required nutrients to improve long-term health
• C. DRIs specifically address individuals whose requirements are affected by a disease state
• D. The DRIs attempt to establish maximum safe levels of tolerance for nutrients

Correct answer: C

Rationale: The correct answer is C. DRIs are intended for the general population and do not specifically address disease states, which are managed with different clinical guidelines. Choice A is correct as DRIs have replaced the older recommended daily allowances. Choice B is correct as current DRIs aim to estimate the required nutrients for long-term health. Choice D is correct as DRIs also attempt to establish maximum safe levels of tolerance for nutrients.

5. Which medical condition is characterized by symptoms such as oral candidiasis, hairy leukoplakia, herpetic ulcerations, Kaposi's sarcoma, xerostomia, and severe periodontal disease?

• A. Acquired Immunodeficiency Syndrome (AIDS)
• B. Acute Leukemia
• C. Anorexia Nervosa
• D. Bulimia

Correct answer: A

Rationale: Acquired Immunodeficiency Syndrome (AIDS) is known for a variety of oral manifestations such as oral candidiasis, hairy leukoplakia, herpetic ulcerations, Kaposi's sarcoma, xerostomia, and severe periodontal disease. These symptoms are not typically associated with acute leukemia, anorexia nervosa, or bulimia. Acute leukemia usually presents with symptoms like fatigue, frequent infections, and easy bruising. Anorexia nervosa and bulimia are eating disorders, thus their primary symptoms are primarily associated with eating habits and body weight, not oral health.

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