Nursing Elites

1. When teaching a patient with diabetes about foot care, which of the following should the nurse emphasize?

• A. Avoid soaking feet daily to prevent dryness and skin breakdown
• B. Select well-fitting shoes to prevent injury
• C. Trim toenails straight across and file the edges
• D. Avoid using heating pads to prevent burns

Correct answer: C

Rationale: The correct answer is C. Trimming toenails straight across and filing the edges is crucial in diabetic foot care to prevent ingrown toenails and foot injuries. Soaking feet daily can lead to dryness and skin breakdown, increasing the risk of infection. Selecting well-fitting shoes is important to prevent pressure points and skin damage, not tight-fitting shoes. Using heating pads can result in burns or injuries due to decreased sensation in diabetic feet, so it's essential to avoid them.

2. What dietary considerations must the nurse keep in mind for a patient who is an Orthodox Jew?

• A. They can eat any food unless it is Yom Kippur
• B. They cannot mix meat and dairy
• C. They cannot eat meat on Ash Wednesday
• D. They are vegetarian

Correct answer: B

Rationale: Orthodox Jews follow dietary laws (Kashrut) that prohibit mixing meat and dairy products in the same meal. This restriction is known as 'not mixing milk and meat.' Therefore, choice B is the correct answer. Choices A, C, and D are incorrect because being an Orthodox Jew does not mean they can eat any food unless it is Yom Kippur, avoid meat on Ash Wednesday, or are necessarily vegetarian.

3. The nurse is teaching a pregnant client how to distinguish prelabor contractions from true labor contractions. Which statement about prelabor contractions is accurate?

• A. They are irregular
• B. They are usually felt in the abdomen
• C. They start in the back and radiate to the abdomen
• D. They become more intense during walking

Correct answer: B

Rationale: The correct statement about prelabor contractions (Braxton Hicks contractions) is that they are usually felt in the abdomen. They are irregular in nature and do not intensify with movement. Choice A is incorrect because prelabor contractions are irregular, not regular. Choice C is incorrect as prelabor contractions do not start in the back and radiate to the abdomen. Choice D is incorrect as prelabor contractions do not become more intense during walking.

4. A nurse is caring for a 60-year-old man who is scheduled to have coronary bypass surgery in the morning. He tells the nurse that he is afraid that he will die and he is scared of the surgery. What is the best reply for this nurse to give him?

• A. There is no reason to be scared. My father had this surgery, and now he’s playing tennis with his friends almost every day.
• B. I would be scared too. It’s a natural thing to feel. Don’t worry. Everything will be alright.
• C. You’re scared?
• D. The doctor has performed hundreds of successful bypass surgeries. I have a lot of faith in him.

Correct answer: C

Rationale: The best reply for the nurse to give the patient is option C: 'You’re scared?' This response reflects empathy and understanding, acknowledging the patient's feelings of fear. By directly addressing the patient's emotions, the nurse encourages further expression of concerns, which is crucial in providing emotional support. Choices A and D may come off as dismissive of the patient's feelings by downplaying his fear or shifting the focus to others' experiences. Choice B, although acknowledging the patient's fear, does not actively engage with the patient's emotions or encourage further discussion.

5. Which of the following is NOT a second-line agent used for the treatment of Tuberculosis?

• A. Amikacin
• B. Moxifloxacin
• C. Rifabutin
• D. Cycloserine

Correct answer: C

Rationale: The correct answer is C, Rifabutin. Rifabutin is actually a first-line drug used in the treatment of tuberculosis. Choices A, B, and D (Amikacin, Moxifloxacin, and Cycloserine) are considered second-line agents for tuberculosis treatment. These drugs are used when the first-line medications are either ineffective or cannot be tolerated by the patient.

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