Nursing Elites

1. Which nursing diagnosis is a priority for clients with Borderline personality disorder?

• A. Risk for injury
• B. Ineffective individual coping
• C. Altered thought process
• D. Sensory perceptual alteration

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. Which organ produces and secretes bicarbonate ions and insulin?

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

Correct answer: B

Rationale: The pancreas is the correct answer because it performs two vital functions: producing bicarbonate ions to neutralize stomach acid in the small intestine and secreting insulin to regulate blood glucose levels. The stomach is incorrect because its primary function is to break down and digest food, not produce bicarbonate ions or insulin. The large and small intestines are also incorrect because their primary functions are to absorb nutrients and water from food, rather than producing bicarbonate ions or insulin.

3. During the first 24 hours after the thermal injury, you should assess Sergio for:

• A. hypokalemia and hypernatremia
• B. hypokalemia and hyponatremia
• C. hyperkalemia and hyponatremia
• D. hyperkalemia and hypernatremia

Correct answer: D

Rationale: During the initial phase after a thermal injury, the major concern is the release of potassium due to cell damage, leading to hyperkalemia. Hypernatremia is not typically a primary concern in the immediate post-injury phase. Hyponatremia is less likely to occur initially after a burn injury. Therefore, the correct assessment for Sergio during the first 24 hours after the thermal injury would be hyperkalemia and hypernatremia.

4. Match amylase with its digestive action:

• A. breaks down carbs
• B. breaks down proteins
• C. breaks down lipids
• D. helps fat digestion

Correct answer: A

Rationale: The correct answer is A: 'breaks down carbs.' Amylase is an enzyme that specifically targets carbohydrates, breaking them down into simpler sugars like maltose. This process aids in the digestion of carbohydrates in the human body. Choices B, C, and D are incorrect because amylase does not break down proteins, lipids, or directly aid fat digestion. Proteins are broken down by proteases, lipids are broken down by lipases, and fat digestion is primarily assisted by bile salts and lipases in the small intestine.

5. A client with frequent kidney stones is receiving dietary teaching from a nurse. Which of the following instructions should the nurse include?

• A. Limit your intake of dairy products.
• B. Increase your consumption of protein-rich foods.
• C. Avoid eating tree nuts, such as almonds.
• D. Take a vitamin C supplement twice daily.

Correct answer: A

Rationale: The correct answer is to instruct the client to limit their intake of dairy products. Dairy products are high in calcium and can contribute to kidney stone formation in susceptible individuals. Increasing protein intake may lead to higher excretion of calcium, which can exacerbate kidney stone formation. While tree nuts are high in oxalates, which can contribute to kidney stone formation, it is not the primary concern in this case. Vitamin C supplements can increase oxalate levels in the urine, potentially increasing the risk of kidney stone formation, so it should not be recommended.

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