Nursing Elites

1. In the following ingredient list, which is the most abundant by weight? Ingredients: enriched flour, sugars, eggs, soy lecithin, artificial colors, natural flavors, milk.

• A. milk
• B. eggs
• C. sugar
• D. enriched flour

Correct answer: D

Rationale: The correct answer is 'enriched flour.' In ingredient lists, items are typically listed by weight in descending order. Therefore, the first ingredient, in this case, 'enriched flour,' is the most abundant by weight. Choice A, 'milk,' is not the most abundant as it appears last in the list. Choice B, 'eggs,' and choice C, 'sugar,' also rank lower in the list compared to 'enriched flour,' making them less abundant by weight.

2. After bronchoscopy, the nurse's priority is to check which of the following before feeding?

• A. Gag reflex
• B. Wearing off of anesthesia
• C. Swallowing reflex
• D. Peristalsis

Correct answer: A

Rationale: After a bronchoscopy procedure, the nurse's priority is to check the patient's gag reflex before allowing them to eat to prevent aspiration. The gag reflex helps protect the airway by triggering a cough or gag response if something touches the back of the throat. This is crucial to ensure that the patient can protect their airway and prevent food or fluids from entering the lungs, especially when the throat may be sensitive or compromised post-bronchoscopy. Checking for the wearing off of anesthesia, swallowing reflex, or peristalsis are important assessments but not the immediate priority before feeding in this context.

3. What type of drug is lamivudine, used for the management of HIV infection?

• A. CCR5 antagonist
• B. fusion inhibitor
• C. nucleoside reverse transcriptase inhibitor
• D. protease inhibitor

Correct answer: C

Rationale: Lamivudine belongs to the class of nucleoside reverse transcriptase inhibitors (NRTIs), making choice C the correct answer. NRTIs like lamivudine work by inhibiting the reverse transcriptase enzyme, an essential component for the HIV virus to replicate. Choices A, B, and D are incorrect because lamivudine does not function as a CCR5 antagonist, fusion inhibitor, or protease inhibitor in the management of HIV infection.

4. Medication for treating high blood cholesterol levels should not be used for most people unless:

• A. The patient has at least three major risk factors for coronary heart disease
• B. The patient has been experiencing symptoms of coronary heart disease for at least three months
• C. The patient's medical insurance covers prescription drugs
• D. Treatment with Therapeutic Lifestyle Changes (TLC) alone is unsuccessful after three months

Correct answer: D

Rationale: The correct answer is choice D because medication for high cholesterol is typically not considered unless Therapeutic Lifestyle Changes (TLC), which include diet and exercise, have not proven effective after a three-month period. This approach ensures that lifestyle modifications are given a fair chance to lower cholesterol levels before resorting to medication. Choice A is incorrect because the number of risk factors for coronary heart disease does not dictate when to begin medication; it is about the effectiveness of lifestyle changes. Choice B is incorrect as the duration of coronary heart disease symptoms does not determine when to start medication; the focus is on the response to TLC. Choice C is incorrect because the coverage of prescription drugs by the patient's insurance does not influence the medical decision to use medication for high cholesterol; it is based on medical necessity and effectiveness of prior interventions.

5. The most energy-rich nutrient is:

• A. carb
• B. fat
• C. protein
• D. water

Correct answer: B

Rationale: Fat provides 9 kcal per gram, making it the most energy-rich nutrient compared to carbohydrates and proteins, which provide 4 kcal per gram.

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