Nursing Elites

1. During which phase of the therapeutic relationship should the nurse inform the patient about the termination of therapy?

• A. Pre-orientation
• B. Orientation
• C. Working
• D. Termination

Correct answer: D

Rationale: The correct answer is 'Termination'. This phase of the therapeutic relationship is when the nurse informs the patient about the conclusion of therapy. It is during this phase that the nurse and the patient review the goals and progress made and also discuss the upcoming termination. The other phases are not the appropriate times for discussing termination. 'Pre-orientation' is the phase before the nurse-patient relationship is established; 'Orientation' is when the nurse and patient get to know each other and set goals; and 'Working' is when these goals are pursued. Therefore, choices A, B, and C are incorrect.

2. A nurse is teaching a group of adults about nutrition. The nurse should include which of the following amounts as an appropriate daily intake of fiber for adult women?

• A. 5 to 10 g
• B. 10 to 15 g
• C. 20 to 35 g
• D. 40 to 50 g

Correct answer: C

Rationale: The correct answer is 20 to 35 g. This range is the recommended daily intake of fiber for adult women. Fiber is essential for maintaining a healthy digestive system and overall well-being. Option A (5 to 10 g) is too low and may not provide sufficient fiber intake. Option B (10 to 15 g) is also below the recommended range. Option D (40 to 50 g) is too high and can lead to gastrointestinal discomfort and other complications if consumed in excess.

3. 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.

4. Which lipid contains 3 fatty acids?

• A. cholesterol
• B. phospholipid
• C. saturated
• D. triglyceride

Correct answer: D

Rationale: The correct answer is 'D. triglyceride.' Triglycerides are composed of one glycerol molecule and three fatty acids, making them the primary form of stored fat in the body. Cholesterol (A) is a different type of lipid, phospholipids (B) have two fatty acids, and 'saturated' (C) refers to the structure of fatty acids, not a specific lipid containing 3 fatty acids.

5. Which of the following actions would be of highest priority with regards to the external shunt?

• A. Avoid taking blood pressure or blood sample from the arm with the shunt
• B. Instruct the patient not to exercise the arm with the shunt
• C. Heparinize the shunt daily
• D. Change the dressing of the shunt daily

Correct answer: C

Rationale: Heparinizing the shunt daily (choice C) is the highest priority action as it prevents the formation of blood clots that can occlude the shunt, leading to potential complications such as thrombosis. Avoiding taking blood pressure or blood samples from the arm with the shunt (choice A) is also important, but secondary to heparinizing the shunt. Similarly, instructing the patient not to exercise the arm with the shunt (choice B) can help prevent unnecessary strain on the shunt, but it is not as critical as preventing clot formation. Changing the dressing of the shunt daily (choice D) is a standard nursing care practice to prevent infection, but again, it is not as critical as ensuring the shunt remains patent through daily heparinization.

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