Nursing Elites

1. Ms. Maria Salvacion says that she is the incarnation of the holy Virgin Mary. She said that she is the child of the covenant that would save this world from the evil forces of Satan. One morning, while caring for her, she stood in front of you and said “Bow down before me! I am the holy mother of Christ! I am the blessed Virgin Mary!” The best response by the Nurse is:

• A. Tell me more about being the Virgin Mary
• B. So, You are the Virgin Mary?
• C. Excuse me but, you are not anymore a Virgin so you cannot be the Blessed Virgin Mary.
• D. You are Maria Salvacion

Correct answer: B

Rationale: Nursing interventions should be grounded in a deep understanding of the physiological processes involved, ensuring that care provided is both effective and efficient.

2. A client with frequent kidney stones is receiving dietary teaching from a nurse. Which of the following instructions should the nurse include?

• A. Limit your intake of dairy products.
• B. Increase your consumption of protein-rich foods.
• C. Avoid eating tree nuts, such as almonds.
• D. Take a vitamin C supplement twice daily.

Correct answer: A

Rationale: The correct answer is to instruct the client to limit their intake of dairy products. Dairy products are high in calcium and can contribute to kidney stone formation in susceptible individuals. Increasing protein intake may lead to higher excretion of calcium, which can exacerbate kidney stone formation. While tree nuts are high in oxalates, which can contribute to kidney stone formation, it is not the primary concern in this case. Vitamin C supplements can increase oxalate levels in the urine, potentially increasing the risk of kidney stone formation, so it should not be recommended.

3. 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.

4. Which vitamin deficiency is most likely to cause bleeding disorders?

• A. Vitamin A
• B. Vitamin E
• C. Vitamin K
• D. Vitamin D

Correct answer: C

Rationale: Vitamin K is essential for blood clotting as it plays a crucial role in the activation of clotting factors. Deficiency of Vitamin K can lead to impaired blood clotting, resulting in bleeding disorders. Vitamin A is more associated with vision and skin health, not blood clotting. Vitamin E is known for its antioxidant properties and role in immune function, not specifically related to bleeding disorders. Vitamin D plays a key role in calcium absorption and bone health, but it is not directly linked to blood clotting or bleeding disorders.

5. Which two dietary components may help decrease blood cholesterol levels?

• A. Omega-3 fatty acids and soluble fiber
• B. Short-chain fatty acids and insoluble fiber
• C. Trans fatty acids and potassium
• D. Cis fatty acids and calcium

Correct answer: A

Rationale: The correct answer is A: Omega-3 fatty acids and soluble fiber. Omega-3 fatty acids are known to reduce triglycerides, while soluble fiber helps to lower LDL cholesterol levels. Both of these components are beneficial in managing blood cholesterol levels. Choice B, short-chain fatty acids and insoluble fiber, is incorrect as they do not have the same cholesterol-lowering effects as omega-3 fatty acids and soluble fiber. Choice C, trans fatty acids and potassium, is incorrect as trans fatty acids can raise LDL cholesterol levels and increase the risk of heart disease. Choice D, cis fatty acids and calcium, is incorrect as cis fatty acids are common in natural fats and do not specifically help in reducing blood cholesterol levels.

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