Nursing Elites

1. Patients with gallbladder disease should reduce their intake of:

• A. Protein
• B. Sodium
• C. Cholesterol
• D. Fat

Correct answer: D

Rationale: Patients with gallbladder disease are advised to reduce their fat intake because fats can trigger gallbladder symptoms such as pain and bloating. While protein, sodium, and cholesterol may also impact overall health, reducing fat intake specifically helps manage gallbladder-related symptoms effectively. Protein is important for tissue repair, sodium can affect blood pressure, and cholesterol levels impact heart health, but in the context of gallbladder disease, fat reduction is the most beneficial.

2. Which type of anemia is associated with chronic kidney disease?

• A. Iron-deficiency anemia
• B. Vitamin B12 deficiency anemia
• C. Aplastic anemia
• D. Erythropoietin deficiency anemia

Correct answer: D

Rationale: The correct answer is D: Erythropoietin deficiency anemia. Chronic kidney disease often leads to anemia due to decreased production of erythropoietin. This hormone, produced by the kidneys, stimulates red blood cell production in the bone marrow. Iron-deficiency anemia (choice A) is more commonly caused by insufficient dietary iron intake or chronic blood loss. Vitamin B12 deficiency anemia (choice B) is usually due to inadequate dietary intake, malabsorption, or pernicious anemia. Aplastic anemia (choice C) is a bone marrow failure disorder characterized by pancytopenia (decreased red blood cells, white blood cells, and platelets) rather than a deficiency in erythropoietin production.

3. The nurse writes a problem of “potential for complication related to ovarian hyperstimulation” for a client who is taking clomiphene (Clomid), an ovarian stimulant. Which intervention should be included in the plan of care?

• A. Instruct the client to delay intercourse until menses
• B. Schedule the client for frequent pelvic sonograms
• C. Explain that the infusion therapy will take 21 days
• D. Discuss that this may cause an ectopic pregnancy

Correct answer: B

Rationale: Frequent pelvic sonograms help monitor for ovarian hyperstimulation, a serious potential side effect of clomiphene. Instructing the client to delay intercourse until menses (choice A) is not directly related to monitoring or managing ovarian hyperstimulation. Explaining the duration of infusion therapy (choice C) is not relevant to the potential complication of ovarian hyperstimulation. Discussing the risk of ectopic pregnancy (choice D) is important but not the most appropriate intervention for managing ovarian hyperstimulation.

4. Listed below are five categories that identify the responsibilities of the practical nurse manager in personnel management. Which of these categories is most appropriate for the task 'Know what your soldiers are doing during duty hours'?

• A. Accountability
• B. Personal/professional development
• C. Individual training
• D. Military appearance/physical condition

Correct answer: A

Rationale: The correct answer is 'Accountability.' This choice is the most appropriate for the task 'Know what your soldiers are doing during duty hours' as it directly relates to being responsible for and knowing the actions and whereabouts of individuals under supervision. 'Personal/professional development' (choice B) focuses on growth and advancement, 'Individual training' (choice C) pertains to specific skill development, and 'Military appearance/physical condition' (choice D) deals with the physical presentation and health of soldiers, none of which directly address the task of knowing soldiers' activities during duty hours.

5. The nurse on the postsurgical unit received a client that was transferred from the post-anesthesia care unit (PACU) and is planning care for this client. The nurse understands that staff should begin planning for this client’s discharge at which point during the hospitalization?

• A. Is admitted to the surgical unit
• B. Is transferred from the PACU to the postsurgical unit
• C. Is able to perform activities of daily living independently
• D. Has been assessed by the healthcare provider for the first time after surgery

Correct answer: A

Rationale: Discharge planning should begin as soon as the patient is admitted to the surgical unit to ensure a smooth transition. Option A is the correct choice because it marks the initial point in the hospitalization process where discharge planning should start. Options B, C, and D are not the ideal points to begin discharge planning. Option B only signifies a transfer within the hospital, while Option C relates to the patient's independence in activities of daily living, which is not directly linked to discharge planning. Option D, having the patient assessed by the healthcare provider for the first time after surgery, is unrelated to the timing of discharge planning.

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