Nursing Elites

1. The nurse notes that the fall might also cause a possible head injury. The patient will be observed for signs of increased intracranial pressure which include:

• A. Narrowing of the pulse pressure
• B. Vomiting
• C. Periorbital edema
• D. A positive Kernig's sign

Correct answer: C

Rationale: Periorbital edema is a sign of increased intracranial pressure. It is caused by fluid accumulation around the eyes due to compromised drainage. Narrowing of the pulse pressure is more indicative of shock than increased intracranial pressure. While vomiting can be a sign of increased intracranial pressure, it is not as specific as periorbital edema. A positive Kernig's sign is associated with meningitis, not increased intracranial pressure.

2. A vegan patient might be at risk for deficiency in which of the following nutrients?

• A. Vitamin B12
• B. Vitamin C
• C. Carbohydrates
• D. Fiber

Correct answer: A

Rationale: The correct answer is Vitamin B12. Vitamin B12 is primarily found in animal products, so individuals following a vegan diet are at risk of deficiency as they do not consume these sources. Vitamin C, Carbohydrates, and Fiber are not specifically at risk for deficiency in vegan diets as they can be obtained from plant-based sources.

3. A client with a body mass index of 28 is seeking dietary advice. Which of the following actions should the nurse take?

• A. Encourage the client to continue their current daily caloric intake.
• B. Recommend a total fiber intake of 12g per day.
• C. Advise the client to add 500 calories per day to their diet.
• D. Refer the client to a weight-loss support group.

Correct answer: D

Rationale: Referring the client to a weight-loss support group is the most appropriate action for a client with a body mass index of 28. This action can provide the necessary support, guidance, and motivation to help the client achieve their weight loss goals. Encouraging the client to continue their current daily caloric intake (Choice A) may not address the need for weight loss. Recommending a total fiber intake of 12g per day (Choice B) is important for overall health but may not directly address weight loss. Advising the client to add 500 calories per day to their diet (Choice C) would not be beneficial for weight loss in this scenario.

4. People with only one arm or hand may benefit from using a ____ when eating?

• A. dish with suction cups
• B. rocker knife
• C. utensil holder
• D. flexible straw

Correct answer: B

Rationale: A rocker knife is specifically designed for individuals with limited use of one hand or arm, allowing them to cut food easily. This makes it a suitable option for people with only one arm or hand. Choice A, a dish with suction cups, may not directly aid in cutting food with one hand. Choice C, an utensil holder, is not typically used for cutting food. Choice D, a flexible straw, is more related to drinking liquids and not specifically designed to assist in cutting food one-handed.

5. The mother of a drug dependent would never consider referring her son to a drug rehabilitation agency because she fears her son might just become worse while relating with other drug users. The mother’s behavior can be described as:

• A. Unhelpful
• B. Codependent
• C. Caretaking
• D. Supportive

Correct answer: C

Rationale: Effective nursing care involves comprehensive assessments that address all aspects of a patient's condition, ensuring that interventions are appropriately targeted and outcomes are optimized.

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