Nursing Elites

1. Patients with gallbladder disease should reduce their intake of:

• A. Protein
• B. Sodium
• C. Cholesterol
• D. Fat

Correct answer: D

Rationale: Patients with gallbladder disease should reduce their intake of fat because high-fat foods can trigger gallbladder symptoms such as pain and indigestion. While proteins, sodium, and cholesterol may also need to be moderated for overall health, reducing fat intake is particularly crucial for managing gallbladder issues.

2. The nurse is preparing to assist in examining a Hispanic child who was brought to the clinic by the mother. During the assessment of the child, the nurse should take which action(s)?

• A. Admiring the child
• B. Taking the child’s temperature
• C. A, D
• D. Obtaining an interpreter if necessary

Correct answer: C

Rationale: In a multicultural healthcare setting, it's essential for the nurse to build rapport with the child and family. Admiring the child can help establish trust and comfort. Additionally, since the child's mother brought them to the clinic, it's crucial to ensure effective communication. Obtaining an interpreter, if necessary, is vital for clear and accurate information exchange. Taking the child's temperature, while important in a physical assessment, is not specifically highlighted in this scenario. Therefore, choices A and B alone are not sufficient, making the correct answer C, which includes both building rapport by admiring the child and ensuring clear communication by obtaining an interpreter if needed.

3. Where do most peptic ulcers occur?

• A. Esophagus
• B. Stomach
• C. Duodenum
• D. Jejunum

Correct answer: C

Rationale: Most peptic ulcers occur in the duodenum, particularly in cases of duodenal ulcers. Peptic ulcers are most commonly found in the duodenum or the first part of the small intestine. While ulcers can also occur in the esophagus and stomach, they are predominantly located in the duodenum. Therefore, options A, B, and D are incorrect.

4. The client diagnosed with thalassemia, a hereditary anemia, is to receive a transfusion of packed RBCs. The cross-match reveals the presence of antibodies that cannot be cross-matched. Which precaution should the nurse implement when initiating the transfusion?

• A. Start the transfusion at 10-15 mL per hour for 15-30 minutes
• B. Re-crossmatch the blood until the antibodies are identified
• C. Have the client sign a permit to receive uncrossmatched blood
• D. Have the unlicensed nursing assistant stay with the client

Correct answer: A

Rationale: Starting the transfusion slowly at 10-15 mL per hour for 15-30 minutes is essential when the cross-match reveals the presence of antibodies that cannot be cross-matched. This precaution allows the nurse to monitor for any adverse reactions due to the antibodies. Re-crossmatching the blood until the antibodies are identified (choice B) may delay the transfusion process and put the client at risk. Having the client sign a permit to receive uncrossmatched blood (choice C) is not a standard practice and does not address the immediate need for precautions during transfusion. Having the unlicensed nursing assistant stay with the client (choice D) is unrelated to the safe initiation of the transfusion and is not a precaution specific to managing antibodies in blood products.

5. In managing cystic fibrosis, which nutrition therapy is crucial for patients with pancreatic insufficiency?

• A. A low-fat diet to prevent steatorrhea
• B. A low-sodium diet to normalize fluid status
• C. A high-fiber diet to normalize bowel function
• D. Pancreatic enzyme replacement therapy to help digestion

Correct answer: D

Rationale: In cystic fibrosis patients with pancreatic insufficiency, pancreatic enzyme replacement therapy is vital for aiding digestion. This therapy helps compensate for the decreased production of digestive enzymes by the pancreas, enabling the proper breakdown and absorption of nutrients. Options A, B, and C are not the primary focus of nutrition therapy for cystic fibrosis patients with pancreatic insufficiency.

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