Nursing Elites

1. 24 hours after the creation of a colostomy, what should Nurse Violy identify as the normal appearance of the stoma?

• A. Pink, moist, and slightly protruding from the abdomen
• B. Gray, moist, and slightly protruding from the abdomen
• C. Pink, dry, and slightly protruding from the abdomen
• D. Red, moist, and slightly protruding from the abdomen

Correct answer: A

Rationale: Following colostomy surgery, a healthy stoma should appear pink, moist, and slightly protruding from the abdomen, which is why option 'A' is the correct answer. A gray stoma (choice 'B') could indicate poor blood supply or necrosis, which is a serious complication. A dry stoma (choice 'C') is also not normal as it should be moist; a dry stoma may suggest dehydration or other complications. While a stoma can appear red (choice 'D'), this is not typically the normal color; it should usually be pink. Therefore, it's important for healthcare professionals to correctly identify the normal and abnormal appearances of a stoma to ensure proper patient care.

2. A client who has dumping syndrome following a hemi-colectomy should avoid which of the following foods when receiving nutritional teaching from a nurse?

• A. Rice
• B. Poached eggs
• C. Fresh apples
• D. White bread

Correct answer: C

Rationale: Fresh apples should be avoided by a client with dumping syndrome following a hemi-colectomy because they are high in fiber and can exacerbate gastrointestinal symptoms such as diarrhea and bloating. Rice and poached eggs are good options as they are easily digestible and less likely to trigger dumping syndrome symptoms. White bread is also preferable over whole grain bread due to its lower fiber content, making it a better choice for individuals with dumping syndrome.

3. Metabolic control is especially important for women with gestational diabetes to ensure the infant does not develop:

• A. microsomia
• B. macrosomia
• C. type 1 diabetes
• D. type 2 diabetes

Correct answer: B

Rationale: Metabolic control is crucial for women with gestational diabetes to prevent the development of macrosomia, which is characterized by an abnormally large baby. This condition poses risks such as birth injuries and necessitates careful management of blood sugar levels. Microsomia is not a known term related to this context. Type 1 and type 2 diabetes are not conditions the infant would develop as a result of gestational diabetes in the mother.

4. A nurse is teaching about nutrition to a client who has a new diagnosis of chronic kidney disease. Which of the following recommendations should the nurse include in the teaching?

• A. Increase phosphorus intake
• B. Limit calcium intake
• C. Limit protein intake
• D. Increase potassium intake

Correct answer: C

Rationale: The correct recommendation for a client with chronic kidney disease is to limit protein intake. Excessive protein consumption can strain the kidneys as they work to eliminate waste products from protein metabolism. This can worsen kidney function in individuals with chronic kidney disease. Therefore, limiting protein intake is crucial in managing this condition. Choices A, B, and D are incorrect. Increasing phosphorus intake can be harmful in kidney disease as it can lead to mineral imbalances. Limiting calcium intake is not typically necessary unless the client has specific complications. Increasing potassium intake may also be inappropriate as potassium levels can be affected in kidney disease.

5. What best describes a task of the registered dietitian?

• A. administering total parenteral nutrition
• B. administering formula through feeding tubes
• C. prescribing diet orders
• D. conducting nutrition assessments

Correct answer: D

Rationale: The correct answer is D, conducting nutrition assessments. Registered dietitians are responsible for assessing an individual's nutritional status, dietary intake, and health needs. This assessment forms the basis for developing personalized nutrition care plans. Choices A and B involve the administration of specialized nutrition support, which is typically done by healthcare providers with specific training in those areas. Choice C, prescribing diet orders, may fall outside the scope of practice for a dietitian as they focus more on assessment, education, and counseling related to nutrition rather than prescribing medical treatments.

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