Nursing Elites

1. A patient is admitted to the emergency room and is found to have proteinuria, a low serum albumin level, edema, and elevated blood lipids. Which condition do these symptoms typically associate with?

• A. Nephrotic syndrome
• B. Acute kidney injury
• C. Rejection of a kidney transplant
• D. Renal colic

Correct answer: A

Rationale: The correct answer is A: Nephrotic syndrome. Nephrotic syndrome is characterized by proteinuria (excess protein in urine), hypoalbuminemia (low serum albumin), edema (swelling due to fluid buildup), and hyperlipidemia (elevated blood lipids). These symptoms occur as a result of damage to the kidneys' filtering units. Acute kidney injury, rejection of a kidney transplant, and renal colic do not present with the same combination of symptoms as nephrotic syndrome. Acute kidney injury typically presents with a sudden decrease in kidney function, resulting in a build-up of waste products in the blood. Rejection of a kidney transplant may present with fever, pain at the transplant site, and changes in urine output. Renal colic usually presents with intense pain in the lower back or side, related to kidney stones.

2. What dietary strategy would most likely be used as part of lifestyle management to reduce the risk of coronary heart disease?

• A. Avoid foods that contain polyunsaturated fat
• B. Limit saturated fat to less than 10 percent of total calories
• C. Limit alcohol intake to one drink daily for women and two drinks daily for men
• D. Avoid consumption of fish and shellfish

Correct answer: C

Rationale: Limiting alcohol intake is part of a strategy to reduce the risk of coronary heart disease by avoiding the negative cardiovascular effects associated with excessive alcohol consumption.

3. What is the purpose of a chest tube after a lobectomy procedure, as understood by the nurse?

• A. Prevent mediastinal shift
• B. Promote chest expansion of the remaining lung
• C. Drain fluids and blood accumulated post-operatively
• D. Remove the air in the lungs to promote lung expansion

Correct answer: C

Rationale: After a lobectomy, a chest tube is typically inserted to drain fluids and blood that may have accumulated post-operatively. This tube helps to prevent complications, such as infections or pneumonia, and aids in patient recovery. While a chest tube may aid in preventing a mediastinal shift (Choice A), promoting chest expansion of the remaining lung (Choice B), and removing air in the lungs to promote lung expansion (Choice D), these are not the primary reasons for its use after a lobectomy. Therefore, Choices A, B, and D are incorrect.

4. Which of the following converts starch to disaccharides, and this reaction occurs in the _____?

• A. pancreatic amylases, small intestine
• B. brush border enzymes, small intestine
• C. luminal enzymes, large intestine
• D. pancreatic amylases, pancreas

Correct answer: A

Rationale: The correct answer is A. Pancreatic amylases break down starch into disaccharides in the small intestine. This process occurs in the small intestine, not the large intestine or pancreas. Brush border enzymes act on disaccharides to break them down into monosaccharides, while luminal enzymes are not specifically involved in the conversion of starch to disaccharides.

5. What is the function of the gallbladder?

• A. to store bile
• B. to produce bile
• C. to digest bile
• D. to modify bile to a liquid form

Correct answer: A

Rationale: The correct answer is A: "to store bile." The gallbladder acts as a reservoir for bile produced by the liver. It releases bile into the small intestine to aid in the digestion of fats. Choice B is incorrect because the liver produces bile, not the gallbladder. Choice C is incorrect as the gallbladder does not digest bile but stores and releases it for digestion. Choice D is incorrect because bile is already in liquid form; the gallbladder does not modify it to a liquid state.

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