Nursing Elites

1. In which type of shock does the patient experience a mismatch of blood flow to the cells?

• A. Distributive
• B. Cardiogenic
• C. Hypovolemic
• D. Septic

Correct answer: A

Rationale: The correct answer is A: Distributive shock. Distributive shock is characterized by a widespread increase in vascular permeability leading to a relative hypovolemia and a mismatch of blood flow to the cells. Choice B, Cardiogenic shock, is due to the heart's inability to pump effectively. Choice C, Hypovolemic shock, results from a decrease in intravascular volume. Choice D, Septic shock, is caused by a systemic response to infection.

2. A nurse is initiating continuous enteral feedings for a client who has a new gastrostomy tube. Which of the following actions should the nurse take?

• A. Measure the client’s gastric residual every 12 hours.
• B. Obtain the client’s electrolyte levels every 4 hours.
• C. Keep the client’s head elevated at 15° during feedings.
• D. Flush the client’s tube with 30 mL of water every 4 hours.

Correct answer: D

Rationale: Flushing the client’s tube with 30 mL of water every 4 hours is essential to maintain tube patency and prevent blockages. This action helps ensure the continuous flow of enteral feedings without obstruction. Measuring the client’s gastric residual every 12 hours (Choice A) is important but not the priority when initiating enteral feedings. Obtaining the client’s electrolyte levels every 4 hours (Choice B) is unnecessary and not directly related to tube feeding initiation. Keeping the client’s head elevated at 15° during feedings (Choice C) is a good practice to prevent aspiration, but tube flushing is more crucial to prevent tube occlusion.

3. Carmen discovers that the DASH diet contains more fiber and ____ compared to that of the typical American diet.

• A. vitamin C
• B. iron
• C. potassium
• D. sodium

Correct answer: C

Rationale: The correct answer is C: 'potassium.' The DASH diet is rich in potassium, which helps lower blood pressure, making it more effective than the typical American diet, which is often low in this essential mineral. Choice A, 'vitamin C,' is incorrect as the comparison is about fiber and another nutrient, not vitamin C. Choice B, 'iron,' is incorrect as the discussion is about fiber and a mineral that helps lower blood pressure, not iron. Choice D, 'sodium,' is incorrect as the DASH diet actually focuses on reducing sodium intake for better blood pressure control, so it wouldn't be a nutrient found in higher amounts compared to the typical American diet.

4. Which item is typically fortified with iodine to address iodine deficiency in the population?

• A. Flour
• B. Salt
• C. Canned vegetables
• D. Drinking water

Correct answer: B

Rationale: Iodized salt is the correct answer. Iodine deficiency can lead to thyroid problems, so iodine is added to salt to ensure an adequate intake of this essential nutrient. Flour is often fortified with other nutrients like folic acid, iron, and niacin, but not iodine. Canned vegetables and drinking water are not typically fortified with iodine to address deficiency in the population.

5. Mr. CKK is unconscious and was brought to the E.R. Who among the following can give consent for CKK's operation?

• A. Doctor
• B. Nurse
• C. Next of Kin
• D. The Patient

Correct answer: A

Rationale: In the scenario described, when a patient is unconscious and unable to provide consent, the responsibility usually falls on the physician to make decisions regarding the patient's treatment, including obtaining consent for an operation. While nurses play a crucial role in patient care, they typically do not have the authority to provide consent for a major procedure. The next of kin may be consulted for input, but the ultimate decision-making authority lies with the physician. The patient, being unconscious, is unable to provide consent in this situation.

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