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. Which of the following nutrients does not provide energy?

• A. Proteins
• B. Carbohydrates
• C. Fats
• D. Vitamins

Correct answer: D

Rationale: Proteins, carbohydrates, and fats are macronutrients that provide energy in the form of calories when consumed and metabolized by the body. Each gram of protein or carbohydrate provides about 4 calories, and each gram of fat provides about 9 calories. On the other hand, vitamins do not provide energy or calories. They are micronutrients that are essential for various biochemical and physiological processes in the body, including the metabolism of macronutrients. However, they do not contribute directly to the energy supply. Therefore, the correct answer is 'D: Vitamins'. Choices A, B, and C (Proteins, Carbohydrates, and Fats) are incorrect because they are macronutrients that do provide energy/calories when metabolized.

3. A nurse is caring for a client following an appendectomy. The nurse verifies the postoperative prescription which reads, 'Discontinue NPO status; advance diet as tolerated.' Which of the following are appropriate for the nurse to offer the client? (SATA)

• A. Wheat toast
• B. Applesauce
• C. Applesauce, Chicken broth
• D. Chicken broth

Correct answer: C

Rationale: The correct answer is C: Applesauce and chicken broth. After an appendectomy, patients are typically started on a clear liquid diet before advancing to more solid foods. Applesauce and chicken broth are part of a low-residue diet that is easily digestible and gentle on the digestive system, making them suitable choices for a client following surgery. Wheat toast may be too heavy and fibrous initially, while other solid foods should be introduced gradually to prevent gastrointestinal upset.

4. In obtaining a urine specimen for culture and sensitivity on a catheterized patient, the nurse is correct if:

• A. Clamp the catheter for 30 minutes, Alcoholize the tube above the clamp site, Obtain a sterile syringe and draw the
• B. Alcoholize the self sealing port, obtain a sterile syringe and draw the specimen on the self sealing port
• C. Disconnect the drainage bag, obtain a sterile syringe and draw the specimen from the drainage bag
• D. Disconnect the tube, obtain a sterile syringe and draw the specimen from the tube

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. During times of staff and financial shortage, which method is the best and most effective?

• A. Functional Method
• B. Primary Nursing
• C. Team Nursing
• D. Modular Method

Correct answer: D

Rationale: During times of staff and financial shortage, the Modular Method is considered the best and most effective. This method allows for flexibility and adaptability in assigning tasks and responsibilities, making it easier to cope with limited resources. Functional Method (Choice A) focuses on the division of labor based on each staff member's skills, which may not be the most efficient during shortages. Primary Nursing (Choice B) and Team Nursing (Choice C) may require a more significant number of staff, making them less suitable during shortages.

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