Nursing Elites

1. Which of the following actions would be of highest priority with regards to the external shunt?

• A. Avoid taking blood pressure or blood sample from the arm with the shunt
• B. Instruct the patient not to exercise the arm with the shunt
• C. Heparinize the shunt daily
• D. Change the dressing of the shunt daily

Correct answer: C

Rationale: Heparinizing the shunt daily (choice C) is the highest priority action as it prevents the formation of blood clots that can occlude the shunt, leading to potential complications such as thrombosis. Avoiding taking blood pressure or blood samples from the arm with the shunt (choice A) is also important, but secondary to heparinizing the shunt. Similarly, instructing the patient not to exercise the arm with the shunt (choice B) can help prevent unnecessary strain on the shunt, but it is not as critical as preventing clot formation. Changing the dressing of the shunt daily (choice D) is a standard nursing care practice to prevent infection, but again, it is not as critical as ensuring the shunt remains patent through daily heparinization.

2. Which of the following proteins is iron a component of, responsible for the transport of oxygen in the bloodstream?

• A. hemoglobin
• B. transferrin
• C. myoglobin
• D. hepcidin

Correct answer: A

Rationale: The correct answer is A: hemoglobin. Hemoglobin is the protein found in red blood cells that is responsible for carrying oxygen from the lungs to the rest of the body. Iron is a crucial component of hemoglobin, binding to oxygen and allowing for its transport. Choice B, transferrin, is involved in iron transport in the blood but not in oxygen transport. Choice C, myoglobin, is a protein found in muscle cells that stores oxygen for muscle use, not transportation in the bloodstream. Choice D, hepcidin, is a peptide hormone that regulates iron absorption in the intestines and iron distribution in the body, but it is not directly involved in oxygen transport.

3. Which vitamin deficiency is most likely to cause bleeding disorders?

• A. Vitamin A
• B. Vitamin E
• C. Vitamin K
• D. Vitamin D

Correct answer: C

Rationale: Vitamin K is essential for blood clotting as it plays a crucial role in the activation of clotting factors. Deficiency of Vitamin K can lead to impaired blood clotting, resulting in bleeding disorders. Vitamin A is more associated with vision and skin health, not blood clotting. Vitamin E is known for its antioxidant properties and role in immune function, not specifically related to bleeding disorders. Vitamin D plays a key role in calcium absorption and bone health, but it is not directly linked to blood clotting or bleeding disorders.

4. A nurse is completing an admission assessment on an adolescent client who is a vegetarian. He eats milk products but does not like beans. Which of the following items should the nurse suggest the client order for lunch to provide the nutrients most likely to be lacking in his diet?

• A. Peanut butter and jelly sandwich
• B. Baked potato topped with sour cream
• C. Bagel with cream cheese
• D. Fruit salad

Correct answer: D

Rationale: The correct answer is 'Fruit salad.' Since the adolescent client is a vegetarian who eats milk products but does not like beans, suggesting a fruit salad for lunch would provide essential nutrients like vitamins, minerals, and fiber that are commonly found in fruits. Fruit salad can help supplement the nutrients that may be lacking in his diet. Choices A, B, and C do not offer the same variety and quantity of nutrients as a fruit salad, making them less optimal choices for meeting the client's dietary needs.

5. Macronutrients include each of the following except one. Which one is the exception?

• A. Fat
• B. Polyunsaturated fatty acids
• C. Carbohydrate
• D. Protein

Correct answer: D

Rationale: Macronutrients are nutrients required by the body in large amounts to provide energy and include carbohydrates, fats, and proteins. While protein is essential for the body, it is not classified as a macronutrient. Proteins are made up of amino acids and serve various functions in the body, such as building and repairing tissues, but they are not a direct energy source like carbohydrates and fats. Therefore, protein is the exception among the listed options, making it the correct answer. Choice A, Fat, Choice B, Polyunsaturated fatty acids, and Choice C, Carbohydrate, are all examples of macronutrients that provide energy and support various bodily functions.

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