Nursing Elites

1. Where should a nurse auscultate the apex beat?

• A. At the fifth intercostal space, along the midclavicular line
• B. At the mid-sternum
• C. 2 inches to the left of the lower end of the sternum
• D. 1 inch to the left of the xiphoid process

Correct answer: A

Rationale: The correct location to auscultate the apex beat is at the fifth intercostal space, along the midclavicular line. This is where the apical impulse, also known as the point of maximal impulse (PMI), can be best heard. Choices B, C, and D are incorrect anatomical locations for auscultating the apex beat, which makes them incorrect choices. Auscultating at the correct location allows healthcare providers to assess the heart's function and detect any abnormalities in heart sounds, which is crucial for comprehensive patient care.

2. How long can Vitamin A be stored in the liver for at least?

• A. 1 month.
• B. 6 months.
• C. 1 year.
• D. 18 months.

Correct answer: C

Rationale: Vitamin A can be stored in the liver to meet basic needs for at least 1 year. This storage capacity allows the body to have a reserve of Vitamin A to sustain its needs over an extended period. Choices A, B, and D are incorrect because they underestimate the storage capacity of Vitamin A in the liver, which can last longer than these durations.

3. A client is being prepared for placement of a catheter for total parenteral nutrition. Which of the following access sites should be planned for catheter insertion?

• A. Left antecubital vein
• B. Right subclavian vein
• C. Right femoral artery
• D. Left arm radial artery

Correct answer: B

Rationale: The correct answer is the Right subclavian vein. When preparing a client for placement of a catheter for total parenteral nutrition, the preferred access site for catheter insertion is the subclavian vein due to its large size, central location, and lower risk of infection compared to peripheral veins. The other options provided (Left antecubital vein, Right femoral artery, and Left arm radial artery) are not suitable access sites for central venous catheter insertion for total parenteral nutrition.

4. Which organ absorbs water and vitamin K and may be affected by ulcerative colitis?

• A. Stomach
• B. Pancreas
• C. Large intestine
• D. Small intestine

Correct answer: C

Rationale: The large intestine is the organ that is primarily responsible for the absorption of water and vitamin K in the human body. A disease like ulcerative colitis can disrupt these functions by causing inflammation and ulcers in the lining of the large intestine, leading to digestive issues. The stomach (Choice A) primarily functions to break down and digest food, not to absorb water and vitamins. The pancreas (Choice B) secretes enzymes to aid in digestion and hormones to regulate blood sugar, but does not absorb water and vitamins. The small intestine (Choice D) is primarily responsible for absorbing nutrients from digested food, but not specifically water and vitamin K. Therefore, these other choices are incorrect.

5. A client with pre-dialysis end-stage kidney disease is being taught about diet. Which of the following instructions should the nurse include?

• A. Increase intake of dietary phosphorus.
• B. Eliminate foods high in protein from your diet.
• C. Reduce intake of foods high in potassium.
• D. Increase intake of sodium-containing foods.

Correct answer: C

Rationale: In pre-dialysis end-stage kidney disease, reducing intake of foods high in potassium is crucial as impaired kidney function can lead to potassium buildup in the blood, which can be dangerous. High potassium levels can cause irregular heartbeats and even cardiac arrest. Therefore, advising the client to reduce potassium-rich foods is essential to prevent complications. Choices A, B, and D are incorrect. Increasing dietary phosphorus, eliminating foods high in protein, or increasing sodium-containing foods are not appropriate recommendations for a client with pre-dialysis end-stage kidney disease as they can exacerbate the condition.

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