Nursing Elites

1. What dietary considerations must the nurse keep in mind for a patient who is an Orthodox Jew?

• A. They can eat any food unless it is Yom Kippur
• B. They cannot mix meat and dairy
• C. They cannot eat meat on Ash Wednesday
• D. They are vegetarian

Correct answer: B

Rationale: Orthodox Jews follow dietary laws (Kashrut) that prohibit mixing meat and dairy products in the same meal. This restriction is known as 'not mixing milk and meat.' Therefore, choice B is the correct answer. Choices A, C, and D are incorrect because being an Orthodox Jew does not mean they can eat any food unless it is Yom Kippur, avoid meat on Ash Wednesday, or are necessarily vegetarian.

2. At one minute after birth, an infant is crying, has a heart rate of 140, has acrocyanosis, resists the suction catheter, and keeps his arms extended and his legs flexed. What is the Apgar score?

• A. 4
• B. 6
• C. 8
• D. 10

Correct answer: C

Rationale: The Apgar score is based on five components: heart rate, respiratory effort, muscle tone, reflex irritability, and color. In this case, the infant has a heart rate over 100 (2 points), is crying (2 points indicating good respiratory effort), resists the catheter (2 points for good reflex irritability), but has acrocyanosis (partial point deduction of 1). Thus, the Apgar score at one minute after birth would be 8. Choice A is incorrect as the given signs indicate a higher score. Choice B is incorrect as the signs described support a score above 6. Choice D is incorrect as it represents a perfect score which is not the case here due to acrocyanosis.

3. What is the most common cause of acute pancreatitis?

• A. Gallstones
• B. Alcohol abuse
• C. Hypertriglyceridemia
• D. Infection

Correct answer: A

Rationale: The correct answer is A: Gallstones. Gallstones are the most common cause of acute pancreatitis as they obstruct the pancreatic duct, leading to inflammation. While alcohol abuse (Choice B) can also cause pancreatitis, gallstones are more prevalent. Hypertriglyceridemia (Choice C) is a less common cause of acute pancreatitis compared to gallstones. Infection (Choice D) is not a primary cause of acute pancreatitis; gallstones are the leading etiology.

4. A client reports being able to swallow only small bites of solid food and liquids for the last 3 months. The PN should assess the client for what additional information?

• A. Past traumatic injury to the neck
• B. Daily consumption of hot beverages
• C. History of alcohol or tobacco use
• D. Daily dietary intake of roughage

Correct answer: C

Rationale: The correct answer is C: History of alcohol or tobacco use. A history of alcohol or tobacco use is significant as both are risk factors for esophageal cancer or other esophageal disorders that could cause difficulty swallowing (dysphagia). This information helps in evaluating the underlying cause of the symptom. Choices A, B, and D are less relevant in this context. While a past traumatic injury to the neck could potentially cause swallowing difficulties, given the chronic nature of the symptom in this case, it is more important to focus on potential risk factors associated with esophageal disorders like alcohol and tobacco use. Daily consumption of hot beverages and daily dietary intake of roughage are less likely to be directly related to the client's current swallowing issue.

5. A client is post-operative day two from a total hip arthroplasty. The nurse notices the surgical wound is red and warm to the touch. What is the most appropriate action?

• A. Apply an ice pack to the incision site.
• B. Monitor the client's temperature.
• C. Document the findings and continue to monitor.
• D. Notify the healthcare provider.

Correct answer: D

Rationale: The correct action when a nurse notices redness and warmth at the surgical wound post total hip arthroplasty is to notify the healthcare provider. These signs may indicate an infection, and prompt evaluation by the healthcare provider is crucial to initiate appropriate treatment. Applying an ice pack (Choice A) may not address the underlying issue of a potential infection. Monitoring the client's temperature (Choice B) is important but not the priority when signs of infection are present. Documenting the findings and continuing to monitor (Choice C) is necessary but should be accompanied by notifying the healthcare provider for further assessment and intervention.

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