Nursing Elites

1. An advance directive known as a durable power of attorney involves appointing another person called a(n) _____ to act as the decision maker in the event of the patient's incapacitation.

• A. witness
• B. primary caregiver
• C. health care agent
• D. state proxy

Correct answer: C

Rationale: The correct answer is 'health care agent.' A health care agent is appointed through a durable power of attorney to make medical decisions on behalf of a patient who becomes incapacitated. The term 'witness' (choice A) is incorrect because a witness only observes the signing of the directive and does not make decisions. 'Primary caregiver' (choice B) is also incorrect as they may provide care but are not necessarily legally empowered to make decisions. 'State proxy' (choice D) is not commonly used in the context of advance directives or health care decision making, making it an incorrect choice.

2. What condition has been shown to be associated with esophageal dysphagia?

• A. myasthenia gravis
• B. achalasia
• C. Alzheimer's disease
• D. cerebral palsy

Correct answer: B

Rationale: Achalasia is the correct answer. It is a condition characterized by the esophagus having difficulty moving food toward the stomach, resulting in dysphagia (difficulty swallowing). Myasthenia gravis (Choice A) is a neuromuscular disorder that affects skeletal muscles, not the esophagus. Alzheimer's disease (Choice C) primarily affects cognitive function, not the esophagus. Cerebral palsy (Choice D) is a neurological disorder affecting body movement and muscle coordination, unrelated to esophageal dysphagia.

3. Why is there an ethical dilemma?

• A. Because the law does not clearly state what is right from what is wrong
• B. Because morality is subjective and it differs from each individual
• C. Because the patient's right coincide with the nurse's responsibility
• D. Because the nurse lacks ethical knowledge to determine what action is correct and what action is unethical

Correct answer: C

Rationale: The correct answer is C because an ethical dilemma arises when the patient's rights conflict with the nurse's responsibilities, requiring a careful balance to ensure ethical care delivery. Choices A and B are incorrect because ethical dilemmas are not solely about legal or subjective moral issues. Choice D is incorrect as nurses are generally equipped with ethical knowledge through education and training, and ethical dilemmas are more about conflicting values and responsibilities rather than a lack of knowledge.

4. Which nursing diagnosis has nutritional implications?

• A. impaired dentition
• B. disruption of gas exchange
• C. self-esteem disturbance
• D. sleep pattern disturbance

Correct answer: A

Rationale: Impaired dentition affects a patient's ability to chew and consume a variety of foods, leading to potential nutritional deficiencies and malnutrition.

5. What is the digestive action of bile?

• A. It breaks down carbohydrates
• B. It breaks down proteins
• C. It breaks down lipids
• D. It aids in fat digestion

Correct answer: D

Rationale: Bile, which is produced by the liver and stored in the gallbladder, aids in the digestion of fats. It does this by emulsifying the fats, which makes them easier for the digestive enzymes, such as lipase, to break down. While choices A, B, and C could be seen as partially correct since fats are a type of lipid and the process of breaking down fats could be seen as breaking down lipids, the most accurate answer is D, as the primary function of bile is to aid in fat digestion, not the digestion of all types of lipids or the digestion of proteins or carbohydrates.

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