Nursing Elites

1. Before administering an MMR (measles, mumps, and rubella) vaccine to a 15-month-old, which question should the nurse ask the mother of the child?

• A. “Has your child had any sore throats?”
• B. “Has your child been eating properly?”
• C. “Is your child allergic to any antibiotics?”
• D. “Has your child been exposed to any infections?”

Correct answer: C

Rationale: The correct question for the nurse to ask the mother before administering the MMR vaccine to a 15-month-old is about the child's allergy to antibiotics. This is crucial because the MMR vaccine contains neomycin, an antibiotic, and being allergic to antibiotics like neomycin is a contraindication for the MMR vaccine. Asking about sore throats, eating habits, or exposure to infections is not directly relevant to the administration of the MMR vaccine.

2. For a patient with a history of liver disease, which type of diet is most appropriate?

• A. High-protein
• B. High-carbohydrate
• C. Low-protein
• D. Low-fat

Correct answer: D

Rationale: For a patient with a history of liver disease, a low-fat diet is most appropriate. Liver disease can impair fat metabolism, leading to fat accumulation in the liver cells and worsening the condition. A low-fat diet helps reduce stress on the liver and manage symptoms associated with liver disease. High-protein diets may not be suitable for individuals with liver disease as they can increase the risk of hepatic encephalopathy. High-carbohydrate diets may lead to insulin resistance and fat accumulation in the liver. While protein restriction may be necessary in some cases, a balanced intake of high-quality protein is essential for maintaining muscle mass and overall health, making a low-protein diet not the most appropriate choice for all patients with liver disease.

3. The two members of the health care team who work closely to monitor drug-nutrient interactions are:

• A. Physician and nurse
• B. Physician and pharmacist
• C. Nurse and clinical dietitian
• D. Clinical dietitian and pharmacist

Correct answer: D

Rationale: Clinical dietitians and pharmacists work together to manage drug-nutrient interactions. They have the expertise to understand how medications and nutrients can interact in the body, potentially affecting the effectiveness of treatment. Physicians and nurses may be involved in patient care, but when it comes to monitoring drug-nutrient interactions, the specialized knowledge of clinical dietitians and pharmacists is crucial. Nurses and physicians typically focus more on administering medications and managing overall patient care, rather than the specific interactions between drugs and nutrients.

4. The nurse is caring for the client one day postoperative sigmoid colostomy operation. Which independent nursing intervention should the nurse implement?

• A. Change the infusion rate of the intravenous fluid
• B. Encourage the client to discuss his or her feelings
• C. Administer opioid narcotic medications for pain management
• D. Assist the client out of bed to sit in the chair twice daily

Correct answer: D

Rationale: Assisting the client to sit in a chair is an essential nursing intervention postoperatively as it helps promote circulation, prevent complications like blood clots, and aids in the recovery process. Changing the infusion rate of intravenous fluid (Choice A) requires a physician's order and is not an independent nursing intervention. Encouraging the client to discuss feelings (Choice B) is important for emotional support but not as crucial as physical care immediately postoperatively. Administering opioid narcotic medications (Choice C) for pain management should be based on a prescribed schedule and assessment rather than being an independent nursing action.

5. The nurse is aware that norepinephrine is secreted by which endocrine gland?

• A. The pancreas
• B. The adrenal cortex
• C. The adrenal medulla
• D. The anterior pituitary gland

Correct answer: C

Rationale: The correct answer is C: The adrenal medulla. Norepinephrine is secreted by the adrenal medulla and is involved in the body's 'fight or flight' response. The pancreas (choice A) secretes insulin and glucagon, not norepinephrine. The adrenal cortex (choice B) secretes hormones like cortisol and aldosterone, but not norepinephrine. The anterior pituitary gland (choice D) secretes various hormones like growth hormone and thyroid-stimulating hormone, but not norepinephrine.

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