Nursing Elites

1. The mechanism behind most CKD in patients without diabetes is mediated by:

• A. enzyme systems
• B. immune systems
• C. catabolic systems
• D. hormonal systems

Correct answer: B

Rationale: In non-diabetic patients, CKD is often mediated by immune system responses. Chronic inflammation triggered by immune system dysfunction can contribute to progressive kidney damage. Therefore, the correct answer is 'immune systems.' Choices A, C, and D are incorrect because CKD in non-diabetic patients is primarily associated with immune system abnormalities rather than enzyme, catabolic, or hormonal systems.

2. For an incontinent elderly client who frequently wets his bed and develops redness and skin excoriation at the perianal area, what is the best nursing goal?

• A. Ensure that the bed linen is always dry
• B. Frequently check the bed for wetness and keep it dry
• C. Place a rubber sheet under the client's buttocks
• D. Keep the patient clean and dry

Correct answer: A

Rationale: The best nursing goal for an incontinent elderly client with skin excoriation is to ensure that the bed linen is always dry. This helps in preventing further skin breakdown and promoting skin integrity. Choice B, to frequently check the bed for wetness and keep it dry, may not address the issue of prevention if the linen is not consistently dry. Choice C, placing a rubber sheet under the client's buttocks, focuses more on protecting the mattress rather than addressing the client's skin condition directly. Choice D, keeping the patient clean and dry, is important but does not specifically address the preventive aspect of maintaining dry bed linen.

3. A nurse is caring for a client following a CVA and observes the client experiencing severe dysphagia. The nurse notifies the provider. Which of the following nutritional therapies will likely be prescribed?

• A. NPO until dysphagia subsides
• B. Supplements via nasogastric tube
• C. Initiation of total parenteral nutrition
• D. Soft residue diet

Correct answer: B

Rationale: In the scenario of severe dysphagia following a CVA, the client may have difficulty swallowing and require alternative nutritional support. Providing supplements via a nasogastric tube allows for the delivery of essential nutrients directly into the stomach, bypassing the swallowing difficulties. NPO (nothing by mouth) until dysphagia subsides may be too restrictive for the client's nutritional needs. Initiation of total parenteral nutrition is usually reserved for cases where enteral feeding is not possible or contraindicated. A soft residue diet may not be suitable for a client experiencing severe dysphagia.

4. A client scheduled for hysterosalpingography needs health teaching before the procedure. The nurse is correct in telling the patient that:

• A. She needs to void prior to the procedure
• B. A full bladder is needed prior to the procedure
• C. Painful sensation is felt as the needle is inserted
• D. Flushing sensation is felt as the dye in injected

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. Does the reduction in oxidative damage that occurs with energy restriction in animals also occur in people whose diets include _____?

• A. fiber and carbohydrates
• B. fatty acids and protein
• C. probiotics
• D. antioxidants and phytochemicals

Correct answer: D

Rationale: The correct answer is 'antioxidants and phytochemicals'. Antioxidants and phytochemicals help reduce oxidative damage in the body, contributing to healthy aging and a lower risk of chronic diseases. This is the same effect observed in animals when their energy intake is restricted. The other choices are incorrect as there is no direct evidence connecting reduced oxidative damage with diets high in fiber and carbohydrates, fatty acids and protein, or probiotics.

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