Nursing Elites

1. A patient with a history of gout should avoid which type of food?

• A. Red meat
• B. Chicken
• C. Fish
• D. Dairy

Correct answer: A

Rationale: The correct answer is A: Red meat. Red meat is high in purines, which can exacerbate gout attacks. Gout is a form of arthritis that occurs when high levels of uric acid in the blood lead to the formation of urate crystals in the joints. Purine-rich foods can increase uric acid levels, leading to gout symptoms. Chicken and fish are lower in purines compared to red meat, making them better choices for individuals with gout. Dairy products are generally considered safe for gout patients and may even have a protective effect against gout.

2. The nurse is analyzing laboratory values for the assigned clients. Which finding, based on the client's medical history, indicates the need for immediate follow-up?

• A. Client with chronic kidney disease and serum creatinine of 1.6 mg/dL
• B. Client with diabetes mellitus and a glycosylated hemoglobin A1c (HbA1c) of 7.0%
• C. Client with heart failure and a B-type natriuretic peptide (BNP) of 140 pg/mL
• D. Client who is male and has anemia with hemoglobin of 16.5 g/dL and hematocrit of 45%

Correct answer: B

Rationale: An HbA1c of 7.0% in a client with diabetes mellitus indicates poor long-term glucose control, necessitating immediate follow-up. Choice A, chronic kidney disease with a serum creatinine of 1.6 mg/dL, though concerning, does not indicate an immediate need for follow-up. Choice C, heart failure with a BNP of 140 pg/mL, may require monitoring but not immediate follow-up. Choice D, a male client with anemia and normal hemoglobin and hematocrit levels, does not warrant immediate attention based on the provided information.

3. The type of lipoprotein that carries cholesterol from tissues to the liver for excretion is:

• A. Very low-density lipoprotein
• B. Intermediate-density lipoprotein
• C. Low-density lipoprotein
• D. High-density lipoprotein

Correct answer: D

Rationale: The correct answer is D, High-density lipoprotein (HDL). HDL is known as the 'good' cholesterol and plays a crucial role in transporting cholesterol from tissues back to the liver for excretion. This process helps in reducing the buildup of cholesterol in the bloodstream, thus lowering the risk of heart diseases. Very low-density lipoprotein (Option A), Intermediate-density lipoprotein (Option B), and Low-density lipoprotein (Option C) are not responsible for carrying cholesterol back to the liver for excretion like HDL does. Instead, they are associated with different functions related to cholesterol transportation within the body.

4. The nurse enters a client’s room and the client is demanding release from the hospital. The nurse reviews the client’s record and notes that the client was admitted 2 days ago for treatment of an anxiety disorder, and the admission was voluntary. Which intervention should the nurse initiate first?

• A. Telephone the client’s family and have them persuade the client to stay
• B. Have the client read and sign all the appropriate self-discharge papers
• C. Explain to the client that he cannot leave because he asked for treatment
• D. Notify the client’s healthcare provider of the client’s stated intent to leave the hospital

Correct answer: D

Rationale: The correct intervention for the nurse to initiate first is to notify the client’s healthcare provider of the client’s intention to leave the hospital. This is important to ensure that the client’s care and safety are appropriately managed. Option A is incorrect as involving the family without proper assessment or intervention could violate the client's autonomy. Option B is incorrect because it does not involve the healthcare provider in the decision-making process. Option C is incorrect as it does not address the client's rights to make decisions about their own care.

5. Which of the following is the primary enlisted personnel performing nursing care duties at the various levels of health care?

• A. 68A30
• B. 68WM6
• C. Physician assistant
• D. 6.80E+21

Correct answer: B

Rationale: The correct answer is B: 68WM6. The 68WM6 (Practical Nurse) is the primary enlisted personnel performing nursing care duties. Choice A (68A30) does not correspond to a primary enlisted personnel role in nursing. Choice C (Physician assistant) is not an enlisted personnel role but rather a separate healthcare profession. Choice D (6.80E+21) is a numerical value and does not relate to enlisted personnel performing nursing care duties.

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