Nursing Elites

1. What is the glomerular filtration rate for patients with stage 5 chronic kidney disease (CKD)?

• A. Less than 15 mL/min/1.73 m�
• B. Less than 30 mL/min/1.73 m�
• C. Less than 90 mL/min/1.73 m�
• D. Less than 125 mL/min/1.73 m�

Correct answer: A

Rationale: In patients with stage 5 chronic kidney disease (CKD), also known as end-stage renal disease, the kidney function is significantly compromised. This severe condition is characterized by a glomerular filtration rate (GFR) of less than 15 mL/min/1.73 m�, as correctly stated in choice A. Choices B, C, and D suggest higher GFR values, which are not indicative of stage 5 CKD. Specifically, a GFR of less than 30 mL/min/1.73 m� indicates stage 4 CKD, less than 90 mL/min/1.73 m� signifies stage 3 CKD, and a typical healthy individual usually has a GFR of around 125 mL/min/1.73 m�, which is far above the GFR for stage 5 CKD.

2. Which student lunch is the least nutritious?

• A. Ham sandwich, apple, and milk
• B. Hamburger, fries, and soft drink
• C. Macaroni and cheese, green beans, and peaches
• D. Meatloaf, broccoli, and pear slices

Correct answer: B

Rationale: The correct answer is B - 'Hamburger, fries, and soft drink' as it contains foods high in unhealthy fats, sugars, and low nutritional value. A hamburger, fries, and a soft drink are considered less nutritious compared to the other options. Choice A includes a ham sandwich, apple, and milk, which provide a balance of protein, fiber, and calcium. Choice C consists of macaroni and cheese, green beans, and peaches, offering a mix of carbohydrates, vegetables, and fruits. Choice D contains meatloaf, broccoli, and pear slices, which provide a good source of protein, vitamins, and fiber. Therefore, option B is the least nutritious among the given choices.

3. What is the purpose of a chest tube after a lobectomy procedure, as understood by the nurse?

• A. Prevent mediastinal shift
• B. Promote chest expansion of the remaining lung
• C. Drain fluids and blood accumulated post-operatively
• D. Remove the air in the lungs to promote lung expansion

Correct answer: C

Rationale: After a lobectomy, a chest tube is typically inserted to drain fluids and blood that may have accumulated post-operatively. This tube helps to prevent complications, such as infections or pneumonia, and aids in patient recovery. While a chest tube may aid in preventing a mediastinal shift (Choice A), promoting chest expansion of the remaining lung (Choice B), and removing air in the lungs to promote lung expansion (Choice D), these are not the primary reasons for its use after a lobectomy. Therefore, Choices A, B, and D are incorrect.

4. Which neuromuscular disease is characterized by abnormal chewing and swallowing patterns, tremors of the mandible, lip, and tongue, frequent drooling, and holding food in the mouth for extended periods?

• A. Developmental disabilities
• B. Parkinson's disease
• C. Epilepsy
• D. Diabetes mellitus

Correct answer: B

Rationale: The correct answer is B, Parkinson's disease. Parkinson's disease is characterized by abnormal chewing and swallowing patterns, tremors of the mandible, lip, and tongue, frequent drooling, and difficulties in oral functions like holding food in the mouth. Developmental disabilities (Choice A) do not specifically cause these symptoms related to neuromuscular function. Epilepsy (Choice C) is a neurological disorder characterized by recurrent seizures and does not typically present with the described symptoms. Diabetes mellitus (Choice D) is a metabolic disorder that affects blood sugar regulation and does not directly cause the neuromuscular symptoms mentioned in the question.

5. An adolescent client has bloodshot eyes, a voracious appetite, and dry mouth. Which drug abuse would the nurse most likely suspect?

• A. Marijuana
• B. Amphetamines
• C. Barbiturates
• D. Anxiolytics

Correct answer: A

Rationale: The symptoms described, including bloodshot eyes, a voracious appetite, and dry mouth, are consistent with marijuana use. Bloodshot eyes are a common side effect of marijuana due to its effect on blood vessels in the eyes. Marijuana also often causes an increase in appetite (known as 'the munchies') and can result in dry mouth. Amphetamines typically cause symptoms like increased alertness, energy, and decreased appetite. Barbiturates and anxiolytics would not typically cause bloodshot eyes, a voracious appetite, and dry mouth as described in the scenario. Therefore, the most likely drug abuse the nurse would suspect in this case is marijuana.

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