Nursing Elites

1. A client with frequent kidney stones is receiving dietary teaching from a nurse. Which of the following instructions should the nurse include?

• A. Limit your intake of dairy products.
• B. Increase your consumption of protein-rich foods.
• C. Avoid eating tree nuts, such as almonds.
• D. Take a vitamin C supplement twice daily.

Correct answer: A

Rationale: The correct answer is to instruct the client to limit their intake of dairy products. Dairy products are high in calcium and can contribute to kidney stone formation in susceptible individuals. Increasing protein intake may lead to higher excretion of calcium, which can exacerbate kidney stone formation. While tree nuts are high in oxalates, which can contribute to kidney stone formation, it is not the primary concern in this case. Vitamin C supplements can increase oxalate levels in the urine, potentially increasing the risk of kidney stone formation, so it should not be recommended.

2. This flip-over card is usually kept in a portable file at the Nurse’s Station. It has 2-parts: the activity and treatment section and a nursing care plan section. This carries information about basic demographic data, primary medical diagnosis, current orders of the physician to be carried out by the nurse, written nursing care plan, nursing orders, scheduled tests and procedures, safety precautions in patient care and factors related to daily living activities. This record is used in the charge-of-shift reports or during the bedside rounds or walking rounds. What record is this?

• A. Discharge Summary
• B. Medicine and Treatment Record
• C. Nursing Health History and Assessment Worksheet
• D. Nursing Kardex

Correct answer: C

Rationale: Effective nursing care involves comprehensive assessments that address all aspects of a patient's condition, ensuring that interventions are appropriately targeted and outcomes are optimized.

3. 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.

4. Why might patients with periodontal disease require increased protein intake?

• A. Both the statement and the reason are correct and related
• B. Both the statement and the reason are correct but are not related
• C. The statement is correct, but the reason is not correct
• D. The statement is not correct, but the reason is correct

Correct answer: A

Rationale: Patients with periodontal disease may require increased protein intake due to the physiological response to inflammation and infection, which can negatively impact protein synthesis. Protein is essential for wound healing and tissue repair, and an infection can increase the body's protein requirements. Therefore, ensuring an adequate protein intake is particularly important for these patients. Choice A is correct because the statement and reason are both accurate and directly related to each other, supporting the increased protein needs in patients with periodontal disease. Choices B, C, and D are incorrect as they do not accurately assess the relationship between the statement and the reason provided in the question.

5. Vitamin deficiencies, especially the B-complex vitamins, seldom occur in isolation. Folate, a B-complex vitamin, is the exception because it functions separately from other vitamins.

• 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 first statement is true; the second is false. If a deficiency of one vitamin is suspected, symptoms of other vitamin B deficiencies also may be present. Folate deficiencies usually occur with other nutrient deficiencies. Specifically, folate functions in conjunction with vitamins B12 and C in maintaining normal levels of mature red blood cells.

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