Nursing Elites

1. For an incontinent elderly client who frequently wets his bed and develops redness and skin excoriation at the perianal area, what is the best nursing goal?

• A. Ensure that the bed linen is always dry
• B. Frequently check the bed for wetness and keep it dry
• C. Place a rubber sheet under the client's buttocks
• D. Keep the patient clean and dry

Correct answer: A

Rationale: The best nursing goal for an incontinent elderly client with skin excoriation is to ensure that the bed linen is always dry. This helps in preventing further skin breakdown and promoting skin integrity. Choice B, to frequently check the bed for wetness and keep it dry, may not address the issue of prevention if the linen is not consistently dry. Choice C, placing a rubber sheet under the client's buttocks, focuses more on protecting the mattress rather than addressing the client's skin condition directly. Choice D, keeping the patient clean and dry, is important but does not specifically address the preventive aspect of maintaining dry bed linen.

2. Each of the following is a form of vitamin K, except one. Which is the exception?

• A. Phylloquinone
• B. Tocopherol
• C. Menaquinone
• D. Menadione

Correct answer: B

Rationale: Tocopherol, Choice B, is not a form of vitamin K; it is another name for vitamin E. Phylloquinone (Choice A), menaquinone (Choice C), and menadione (Choice D) are all forms of vitamin K. Phylloquinone is vitamin K1 found in green plants, menaquinone is vitamin K2 produced in the large intestine and found in animal tissues, and menadione is a synthetic form of vitamin K. Therefore, Choice B is the correct answer because it does not belong to the vitamin K group, unlike the other options.

3. What would a diet manual most likely contain?

• A. Procedures for disinfecting cooking surfaces
• B. Staff sanitation guidelines
• C. Information on specific patients' resting metabolic rates
• D. Specific food preparation methods

Correct answer: D

Rationale: A diet manual typically contains guidance on specific food preparation methods to ensure proper nutrition and health for individuals following the diet. Therefore, choice D is correct. Choices A and B refer to sanitation procedures and staff hygiene issues, which are important but not typically the focus of a diet manual. Choice C, regarding specific patients' resting metabolic rates, is too individualized and detailed for a general diet manual, as it would be part of a personalized dietary plan developed with a healthcare professional.

4. The major determinant of a person's total cholesterol levels is the amount of cholesterol in their diet.

• A. True
• B. False
• C.
• D.

Correct answer: B

Rationale: It is false that the major determinant of a person's total cholesterol levels is the amount of cholesterol in their diet. While dietary cholesterol can have some impact on total cholesterol levels, it is not the major determinant. The amount and types of fats consumed, particularly saturated and trans fats, have a more significant impact on blood cholesterol levels. Therefore, a diet high in these types of fats can lead to high cholesterol, irrespective of the amount of dietary cholesterol consumed. This is why it is essential to maintain a balanced diet with a limited intake of saturated and trans fats.

5. A client with pre-dialysis end-stage kidney disease is being taught about diet. Which of the following instructions should the nurse include?

• A. Increase intake of dietary phosphorus.
• B. Eliminate foods high in protein from your diet.
• C. Reduce intake of foods high in potassium.
• D. Increase intake of sodium-containing foods.

Correct answer: C

Rationale: In pre-dialysis end-stage kidney disease, reducing intake of foods high in potassium is crucial as impaired kidney function can lead to potassium buildup in the blood, which can be dangerous. High potassium levels can cause irregular heartbeats and even cardiac arrest. Therefore, advising the client to reduce potassium-rich foods is essential to prevent complications. Choices A, B, and D are incorrect. Increasing dietary phosphorus, eliminating foods high in protein, or increasing sodium-containing foods are not appropriate recommendations for a client with pre-dialysis end-stage kidney disease as they can exacerbate the condition.

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