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. When assessing Richard for chest percussion or chest vibration and postural drainage, Mario would focus on the following EXCEPT:

• A. Amount of food and fluid taken during the last meal before treatment
• B. Respiratory rate, breath sounds, and location of congestion
• C. Teaching the client's relatives to perform the procedure
• D. Doctor's order regarding position restrictions and client's tolerance for lying flat

Correct answer: B

Rationale: The correct answer is B because when assessing Richard for chest percussion or chest vibration and postural drainage, Mario would focus on various aspects such as the amount of food and fluid taken before treatment to prevent complications during the procedure, teaching the client's relatives to perform the procedure correctly, and following the doctor's orders regarding position restrictions and the client's tolerance for lying flat. Respiratory rate, breath sounds, and location of congestion would be assessed during the procedure itself, not as part of the pre-assessment.

3. Which of the following is the least likely reason that osteoporosis is more prevalent in women?

• A. women have smaller bodies
• B. women have lower bone mass
• C. women consume less calcium
• D. bone loss begins later in women

Correct answer: D

Rationale: The correct answer is D. Contrary to the statement, bone loss begins earlier in women, particularly after menopause, due to the decrease in estrogen levels. This drop in estrogen accelerates bone loss, contributing to the higher prevalence of osteoporosis in women. Choices A, B, and C are more likely reasons for the increased prevalence of osteoporosis in women. Women generally have smaller bodies, lower bone mass compared to men, and may consume less calcium, all of which are significant factors contributing to the higher incidence of osteoporosis in women.

4. The nutrient facts panel was established by the USDA and the FDA to improve health and well-being by enhancing nutritional knowledge. Nutrient content claims describe a relationship between a food or food component and reduced risk of a disease or health-related condition.

• A. Both statements are true.
• B. Both statements are false.
• C. The first statement is true; the second is false.
• D. The first statement is false; the second is true.

Correct answer: C

Rationale: The correct answer is C. The first statement is true as the nutrient facts panel was indeed established by the USDA and the FDA to improve health and well-being by enhancing nutritional knowledge. However, the second statement is false. Nutrient content claims actually refer to the amount of a nutrient in a food, not to the relationship between a food and disease risk. Therefore, the second statement is incorrect, making choice C the correct option. Choice A is incorrect because the second statement is false. Choice B is incorrect as the first statement is true. Choice D is incorrect because the second statement is false.

5. Who most often prescribes a patient's diet order?

• A. Registered Nurse
• B. Physician
• C. Registered Dietetic Technician
• D. Occupational Therapist

Correct answer: B

Rationale: A patient's dietary order is most frequently prescribed by a physician. This is because the physician has a comprehensive understanding of the patient's medical condition and can thus determine the most suitable dietary plan. Registered dietitians often collaborate with physicians in this process, but the final prescription is made by the physician. Although registered nurses, dietetic technicians, and occupational therapists play significant roles in patient care, they typically do not prescribe diet orders.

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