Nursing Elites

1. The stages of grieving identified by Elizabeth Kubler-Ross are:

• A. Numbness, anger, resolution and reorganization
• B. Denial, anger, identification, depression and acceptance
• C. Anger, loneliness, depression and resolution
• D. Denial, anger, bargaining, depression and acceptance

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.

2. Toilet training occurs in the anal stage of Freud’s psychosexual development. This is equivalent to Erikson’s:

• A. Trust vs. Mistrust
• B. Autonomy vs. Shame and Doubt
• C. Initiative vs. Guilt
• D. Industry vs. Inferiority

Correct answer: A

Rationale: The correct answer is A: Trust vs. Mistrust. In Freud's psychosexual development theory, the anal stage is where toilet training occurs, focusing on issues of control and independence. This stage is parallel to Erikson's Trust vs. Mistrust stage, where infants learn to trust or mistrust their caregivers based on the consistency of care they receive. Choices B, C, and D are incorrect as they correspond to different stages in Erikson's psychosocial development theory, not related to toilet training or the anal stage of Freud's theory.

3. 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.

4. What food would most likely be included in Level 1 of the National Dysphagia Diet?

• A. peanut butter
• B. oatmeal
• C. fruit preserves
• D. plain yogurt

Correct answer: D

Rationale: The correct answer is D, plain yogurt. Level 1 of the National Dysphagia Diet includes pureed or smooth foods that are easy to swallow. Plain yogurt fits this criteria as it is smooth and can be easily consumed without posing a risk of choking. Choices A, B, and C are not typically included in Level 1 of the diet. Peanut butter, oatmeal, and fruit preserves are not usually suitable for individuals on Level 1 of the National Dysphagia Diet as they may present a choking hazard or are not in a pureed or smooth form.

5. When assessing Richard for chest percussion or chest vibration and postural drainage, Mario would focus on the following EXCEPT:

• A. Amount of food and fluid taken during the last meal before treatment
• B. Respiratory rate, breath sounds, and location of congestion
• C. Teaching the client's relatives to perform the procedure
• D. Doctor's order regarding position restrictions and client's tolerance for lying flat

Correct answer: B

Rationale: The correct answer is B because when assessing Richard for chest percussion or chest vibration and postural drainage, Mario would focus on various aspects such as the amount of food and fluid taken before treatment to prevent complications during the procedure, teaching the client's relatives to perform the procedure correctly, and following the doctor's orders regarding position restrictions and the client's tolerance for lying flat. Respiratory rate, breath sounds, and location of congestion would be assessed during the procedure itself, not as part of the pre-assessment.

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