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. Which of the following terms refers to a process by which an individual receives education about the recognition of stress reactions and management strategies for handling stress, which may be instituted after a disaster?

• A. Critical incident stress management
• B. Follow-up
• C. Debriefing
• D. Defusion

Correct answer: A

Rationale: Critical incident stress management is a process that provides individuals with education about recognizing stress reactions and strategizing management techniques for handling stress after a disaster. Choice B, 'Follow-up', is incorrect because it generally refers to continuing care after initial treatment, not specifically to stress management education. Choice C, 'Debriefing', is a process where individuals involved in a critical event are brought together to discuss the event and their reactions to it. It can be part of the critical incident stress management process, but it doesn't cover the whole process. Choice D, 'Defusion', is a technique used in the immediate aftermath of a traumatic event to help individuals process their experiences, but it does not encompass the full range of education about stress recognition and management strategies.

3. Begins carb digestion in the mouth:

• A. pepsin
• B. salivary amylase
• C. CCK
• D. secretin

Correct answer: B

Rationale: Salivary amylase is the enzyme that begins the digestion of carbohydrates in the mouth by breaking down starches into simpler sugars.

4. What is the priority nursing goal for an adolescent with anorexia nervosa?

• A. Encourage effective coping skills
• B. Restore normal eating habits
• C. Stop weight loss or restore weight
• D. Promote realistic self-image

Correct answer: C

Rationale: The priority nursing goal for an adolescent with anorexia nervosa is to stop weight loss or restore weight. This is crucial in addressing the immediate health risks associated with anorexia nervosa, such as malnutrition, organ damage, and potential life-threatening complications. While encouraging effective coping skills, restoring normal eating habits, and promoting a realistic self-image are important aspects of treatment, stopping weight loss or restoring weight takes precedence due to the severe physical consequences of anorexia nervosa.

5. A nurse is developing a plan of care for a client who has anorexia nervosa. Which of the following actions should the nurse include in the plan?

• A. Encourage the client to participate in developing a system of rewards.
• B. Arrange for someone to remain with the client for 30 minutes after meals.
• C. Offer the client a selection of beverages at each meal.
• D. Inform the client that a weight gain of 2.3 kg per week is expected.

Correct answer: A

Rationale: Encouraging the client to participate in developing a system of rewards is an essential part of the plan of care for a client with anorexia nervosa. This action can help motivate and engage the client in their treatment plan, promoting a sense of achievement and progress. Choice B, arranging for someone to remain with the client for 30 minutes after meals, may not address the underlying issues related to anorexia nervosa and could potentially disrupt the client's independence. Choice C, offering a selection of beverages at each meal, is not directly related to addressing the client's condition of anorexia nervosa. Choice D, informing the client about an expected weight gain, could increase anxiety and may not be appropriate without considering the client's individual progress and readiness.

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