Nursing Elites

1. A common comorbidity in patients with Chronic Kidney Disease (CKD) is:

• A. Liver disease
• B. Malnutrition
• C. Acute renal failure
• D. Difficulty breathing

Correct answer: B

Rationale: Malnutrition is a common comorbidity in patients with Chronic Kidney Disease (CKD). This is mainly due to factors such as dietary restrictions, poor appetite, and the body's increased nutritional needs as it struggles to deal with the disease. Liver disease (Choice A) is not typically associated directly with CKD, although both conditions may coexist in some patients. Acute renal failure (Choice C) is not a comorbidity but a severe and potentially lethal progression of CKD. Difficulty breathing (Choice D) is not a comorbidity but can be a symptom of severe kidney disease or other underlying conditions. However, malnutrition is more commonly observed in CKD patients compared to difficulty breathing.

2. Are the following statements both true: 'Most excess energy intake, whether from protein, carbohydrate, alcohol, or fat, is stored in the liver' and 'Fat is a good source of energy, but the preferred fuel is protein'?

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

Correct answer: B

Rationale: Both of the given statements are false. The first statement is inaccurate because the primary location for excess energy storage is not the liver, but rather adipose tissue where it is stored as fat. While the liver does have a role in energy storage and metabolism, it is not the main storage site for excess intake. The second statement is also incorrect. Although fat and protein can be used as sources of energy, the body's preferred source of energy is carbohydrates. They break down more efficiently and are easier for the body to use. The body prefers to conserve protein for other essential functions, such as tissue repair and the production of enzymes. Therefore, protein is not the preferred fuel source.

3. What is the most appropriate instruction to provide to the parent of a child who does not like a food item?

• A. The child should not be encouraged to try it again.
• B. The child should be offered a reward if they eat most of the food items.
• C. The child should be offered the item at least 8 times on different occasions.
• D. The child should be encouraged to eat at least 5 bites of the food item.

Correct answer: C

Rationale: The correct answer is C. Encouraging repeated exposure to the food item can help the child develop a taste for it. Option A is incorrect as it suggests avoiding encouraging the child to try the food again, which may hinder their ability to develop a liking for it. Option B is incorrect as using rewards for eating may not promote a genuine interest in the food item. Option D is incorrect because setting a specific number of bites may create pressure and negativity around mealtime, rather than fostering a positive association with the food.

4. Earliest sign of skin reaction to radiation therapy is:

• A. desquamation
• B. erythema
• C. atrophy
• D. pigmentation

Correct answer: D

Rationale: Understanding the underlying pathology and therapeutic techniques ensures that nursing care is not only reactive but also preventative, reducing the risk of complications.

5. Which of the following interventions should be considered the highest priority when caring for June, who has hemiparesis secondary to a stroke?

• A. Position June in an upright lateral position
• B. Perform range of motion exercises
• C. Apply antiembolic stockings
• D. Use hand rolls or pillows for support

Correct answer: C

Rationale: The correct answer is C, 'Apply antiembolic stockings'. In the case of a patient who has experienced a stroke and is suffering from hemiparesis, the highest priority intervention is to prevent further complications such as deep vein thrombosis (DVT), which can be life-threatening. Antiembolic stockings are used to increase venous blood flow velocity and reduce the risk of DVT. Choice 'A', positioning June in an upright lateral position, while important for overall care, is not the highest priority. Choice 'B', performing range of motion exercises, is an important part of recovery but not the immediate priority. Choice 'D', using hand rolls or pillows for support, is also a valuable intervention but does not address the most pressing risk of further complications.

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