Nursing Elites

1. You are to apply a transdermal patch of nitoglycerin to your client. The following are important guidelines to observe EXCEPT:

• A. Apply to hairless clean area of the skin not subject to much wrinkling
• B. Patches may be applied to distal part of the extremities like forearm
• C. Change application and site regularly to prevent irritation of the skin
• D. Wear gloves to avoid any medication on your hand

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.

2. During the later stages of chronic kidney disease, what is the recommended protein intake in grams per kilogram of body weight per day?

• A. 0.6 to 0.75
• B. 1.2 to 1.55
• C. 1.0 to 1.2
• D. 0.8 to 1.0

Correct answer: A

Rationale: In the later stages of chronic kidney disease, the recommended protein intake is typically restricted to 0.6 to 0.75 grams per kilogram of body weight per day. This lower protein intake helps reduce the workload on the kidneys, as excessive protein can be challenging for the kidneys to process. Choice B (1.2 to 1.55) is incorrect as it suggests a higher protein intake, which is not recommended for individuals with advanced kidney disease. Choices C (1.0 to 1.2) and D (0.8 to 1.0) also advocate for protein intakes higher than what is typically advised for individuals in later stages of chronic kidney disease.

3. What physiologic role does calcium play in the body?

• A. Blood clotting, transmission of nerve impulses, muscle contraction and relaxation
• B. Calcium homeostasis, structural integrity of heart muscle
• C. No known metabolic function, caries-preventing properties
• D. ATP energy release; metabolism of fats, carbohydrates, proteins; regulates acid-base balance.

Correct answer: A

Rationale: The correct answer is A: 'Blood clotting, transmission of nerve impulses, muscle contraction and relaxation.' Calcium plays a crucial role in various physiological functions such as blood clotting, transmission of nerve impulses, muscle contraction and relaxation, membrane permeability, and activation of certain enzymes. Choice B is incorrect because while calcium is involved in calcium homeostasis, it is not the only role it plays in the body. Choice C is incorrect as calcium indeed has several known metabolic functions, and it is not solely for preventing caries. Choice D is also incorrect as the functions mentioned are primarily carried out by other nutrients and not specifically by calcium.

4. Which list contains fatty acids that reduce cardiovascular disease risk?

• A. omega 3, trans fatty acids, saturated fatty acids
• B. EPA and DHA
• C. omega 6, omega 3, partially hydrogenated oil
• D. omega 3, EPA, saturated fatty acids

Correct answer: B

Rationale: EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid), both omega-3 fatty acids, are known to reduce the risk of cardiovascular disease.

5. 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.

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