Nursing Elites

1. Hypertrophic burn scars are caused by:

• A. exaggerated contraction
• B. random layering of collagen
• C. wound ischemia
• D. delayed epithelialization

Correct answer: C

Rationale: Effective nursing care involves comprehensive assessments that address all aspects of a patient's condition, ensuring that interventions are appropriately targeted and outcomes are optimized.

2. A nurse is caring for four clients. The nurse should plan to administer total parenteral nutrition for which of the following clients?

• A. A client who is postoperative following a laminectomy and is receiving IV PCA
• B. A client who has dysphagia and does not recognize his family
• C. A client who has COPD and is going home with oxygen
• D. A client who has colon cancer and will undergo a hemicolectomy

Correct answer: D

Rationale: Total parenteral nutrition (TPN) is essential for clients undergoing significant surgical procedures like a hemicolectomy to ensure they receive adequate nutrition when oral intake is not possible. Choices A, B, and C do not typically require TPN. Choice A is managing postoperative pain with IV PCA, choice B is likely to need alternative feeding methods due to dysphagia, and choice C is going home with oxygen for COPD management, which does not directly relate to the need for TPN.

3. A healthcare provider is teaching a client who has constipation about a high-fiber diet. Which of the following foods should be included as sources of fiber? (Select one that does not apply.)

• A. Whole wheat bread
• B. Kidney beans
• C. Refined cereals
• D. Blackberries

Correct answer: C

Rationale: Refined cereals are not a good source of fiber as they have been processed and stripped off most of their fiber content. Whole wheat bread, kidney beans, and blackberries are excellent sources of fiber. Whole wheat bread is made from whole grains, which are high in fiber. Kidney beans are rich in fiber and can help alleviate constipation. Blackberries are a good source of fiber and can aid in promoting bowel regularity.

4. A child with ear problem should be assessed for the following, EXCEPT:

• A. is there any fever?
• B. Ear discharge
• C. If discharge is present for how long?
• D. Ear pain

Correct answer: A

Rationale: Patient safety and efficacy of care depend on actions rooted in established nursing protocols that consider both the immediate and long-term needs of the patient.

5. Which set of guidelines is intended to assess nutrient adequacy or plan intakes of population groups, not individuals?

• A. Old Recommended Dietary Allowances (RDA)
• B. Estimated Average Requirement (EAR)
• C. New Recommended Dietary Allowances (RDA)
• D. Tolerable Upper Intake Level (UL)

Correct answer: B

Rationale: The Estimated Average Requirement (EAR) is specifically designed to assess nutrient adequacy or plan intakes for population groups, not for individuals. The Old and New Recommended Dietary Allowances (RDA) are meant for individuals, not groups, as they provide guidelines for specific nutrient intake levels for healthy individuals. The Tolerable Upper Intake Level (UL) is used to set the highest level of nutrient intake that is likely to pose no risk of adverse health effects for most individuals in a group, which is different from assessing nutrient adequacy for groups.

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