Nursing Elites

1. Instruction on health promotion regarding urinary elimination is important. Which would you include?

• A. Hold urine as long as possible before emptying the bladder to strengthen the sphincter muscles
• B. If a burning sensation is experienced while voiding, drink water
• C. After urination, wipe from the anal area towards the pubis
• D. Tell the client to empty the bladder at each voiding

Correct answer: D

Rationale: The correct answer is to instruct the client to empty the bladder at each voiding. This is essential to prevent urinary retention and reduce the risk of urinary tract infections. Choice A is incorrect because holding urine for prolonged periods can lead to urinary retention and increase the risk of infections. Choice B is incorrect as pineapple juice can exacerbate a burning sensation due to its acidity; the correct approach is to drink water to dilute the urine. Choice C is incorrect as wiping from the anal area towards the pubis can introduce bacteria into the urinary tract, potentially causing infections.

2. A client is prescribed a 1500-calorie diet. Thirty percent of the calories are to be derived from fat. How many grams of fat should the nurse tell the client to consume per day? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

• A. 21
• B. 49
• C. 60
• D. 50

Correct answer: D

Rationale: To calculate the grams of fat, first, determine the calories from fat by multiplying the total calorie intake (1500 calories) by the percentage of calories from fat (30%), which equals 450 calories from fat. Since 1 gram of fat is equivalent to 9 calories, divide the total calories from fat (450) by the calories in 1 gram of fat (9) to get the answer in grams, which is 50. Therefore, the client should consume 50 grams of fat per day. Choice A (21), Choice B (49), and Choice C (60) are incorrect as they do not reflect the accurate calculation based on the given information.

3. What is a disadvantage of using a food frequency questionnaire?

• A. It does not influence the food choices of the consumer
• B. It is not affected by seasonal changes in the diet
• C. It is not effective for monitoring short-term changes in food intake
• D. It does not take too long to obtain the results

Correct answer: C

Rationale: Option C is correct because a food frequency questionnaire is designed to capture a person's typical food intake over an extended period and is not suitable for monitoring short-term changes in diet. The questionnaire's purpose is to provide insights into long-term dietary patterns rather than immediate changes. Option A is incorrect as the questionnaire does not influence food choices; it merely records them. Option B is also incorrect because, while seasonal changes can impact food availability and thereby influence diet, the questionnaire itself is not affected by these changes. Lastly, option D is incorrect as the time to obtain results from a food frequency questionnaire would depend on the respondent's speed and accuracy rather than being intrinsically linked to the questionnaire.

4. The following are appropriate nursing interventions during colostomy irrigation, EXCEPT:

• A. Increase the irrigating solution flow rate when abdominal cramps is felt
• B. Insert 2-4 inches of an adequately lubricated catheter to the stoma
• C. Position client in semi-Fowler
• D. Hang the solution 18 inches above the stoma

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. What level of sodium restriction would be included as part of nutrition therapy for heart failure?

• A. Less than 500 mg per day
• B. 1000 mg to 1500 mg per day
• C. 1500 mg to 3000 mg per day
• D. 3000 to 3500 mg per day

Correct answer: C

Rationale: The correct answer is 1500 mg to 3000 mg per day. This is the level of sodium restriction typically recommended for heart failure patients. It helps manage fluid retention and reduce blood pressure, which are both crucial in treating heart failure. A sodium intake of less than 500 mg per day (Choice A) might be too restrictive and is not typically recommended. Similarly, an intake of 1000 mg to 1500 mg per day (Choice B) falls short of the recommended range. Lastly, an intake of 3000 to 3500 mg per day (Choice D) exceeds the recommended upper limit, potentially exacerbating fluid retention and high blood pressure.

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