Nursing Elites

1. Lynn is an older adult who lives alone and has requested advice on how to eat a nutritious diet as cheaply as possible. One useful, practical tip for Lynn might be to _____.

• A. buy just a few pieces of fresh fruit at a time, in different stages of ripeness
• B. choose small boxes of frozen vegetables instead of large bags
• C. purchase pre-sliced or shredded cheese rather than whole pieces
• D. avoid buying certain foods in bulk, such as beans or dried legumes

Correct answer: A

Rationale: Buying a few pieces of fresh fruit at different stages of ripeness ensures that Lynn will have ripe fruit available over several days, reducing waste and cost. Choice B focuses on frozen vegetables but doesn't address the variety and ripeness factor like Choice A. Choice C is about cheese, which may not be as essential for a nutritious diet compared to fresh fruit. Choice D suggests avoiding certain foods in bulk, which might not be as relevant for maintaining a nutritious diet economically as the strategy in Choice A.

2. During the later stages of chronic kidney disease, what is the recommended protein intake in grams per kilogram of body weight per day?

• A. 0.6 to 0.75
• B. 1.2 to 1.55
• C. 1.0 to 1.2
• D. 0.8 to 1.0

Correct answer: A

Rationale: In the later stages of chronic kidney disease, the recommended protein intake is typically restricted to 0.6 to 0.75 grams per kilogram of body weight per day. This lower protein intake helps reduce the workload on the kidneys, as excessive protein can be challenging for the kidneys to process. Choice B (1.2 to 1.55) is incorrect as it suggests a higher protein intake, which is not recommended for individuals with advanced kidney disease. Choices C (1.0 to 1.2) and D (0.8 to 1.0) also advocate for protein intakes higher than what is typically advised for individuals in later stages of chronic kidney disease.

3. Which of the following nursing interventions is appropriate after a total thyroidectomy?

• A. Place pillows under your patient’s shoulders.
• B. Raise the knee-gatch to 30 degrees
• C. Keep you patient in a high-fowler’s position.
• D. Support the patient’s head and neck with pillows and sandbags.

Correct answer: D

Rationale: Understanding the underlying pathology and therapeutic techniques ensures that nursing care is not only reactive but also preventative, reducing the risk of complications.

4. When taking a blood pressure reading, where should the cuff be positioned?

• A. The cuff should be deflated fully before immediately starting a second reading for the same patient
• B. The cuff should be deflated quickly after being inflated to 180 mmHg
• C. The cuff should be large enough to wrap around the upper arm of the adult patient, positioned 1 cm above the brachial artery
• D. The cuff should be inflated to 30 mmHg above the estimated systolic BP based on palpation of the radial or brachial artery

Correct answer: D

Rationale: When measuring blood pressure, the cuff should be inflated to 30 mmHg above the estimated systolic blood pressure based on palpation of the radial or brachial artery. This ensures an accurate blood pressure measurement. Choices A, B, and C are incorrect. Deflating the cuff fully before starting a second reading (Choice A) does not directly relate to the position of the cuff during a reading. Deflating the cuff quickly after inflating to 180 mmHg (Choice B) is not recommended because it can potentially lead to inaccurate readings. While ensuring the cuff is large enough to wrap around the upper arm positioned 1 cm above the brachial artery is important (Choice C), this alone does not guarantee an accurate blood pressure reading. The correct inflation based on palpation is the key element for accuracy, which is why Choice D is correct.

5. Which statement by a client indicates a need for further teaching about food safety?

• A. I will use the food before the expiration date listed on the package.
• B. I will wash my strawberries before I eat them.
• C. I will drink unpasteurized milk as it has many gut-healthy probiotics.
• D. I will wash my hands after I prepare raw chicken.

Correct answer: C

Rationale: The correct answer is C because drinking unpasteurized milk can contain harmful bacteria, which poses a risk to food safety. Choice A is correct as it emphasizes using food before the expiration date. Choice B is also correct as washing fruits before consumption is a good food safety practice. Choice D is correct as well since washing hands after handling raw chicken is crucial to prevent cross-contamination. Therefore, choice C is the only statement that indicates a need for further teaching on food safety.

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