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. A client who is postoperative following a liver transplant and weighs 65 kg. Which of the following actions should the nurse plan to take?

• A. Keep the client NPO for the first week postoperative.
• B. Limit caloric content once the client resumes eating.
• C. Stress the importance of safe food-handling practices.
• D. Decrease foods high in carbohydrates once the client resumes eating.

Correct answer: C

Rationale: After a liver transplant, it is crucial to stress the importance of safe food-handling practices to prevent foodborne illnesses, especially due to the client's altered immune system. Keeping the client NPO for the first week postoperative is not recommended as early nutrition support is essential for recovery. Limiting caloric content once the client resumes eating may not be appropriate as they need adequate nutrition for healing. Decreasing foods high in carbohydrates without a specific indication may lead to inadequate nutrient intake, which is not ideal for the client's recovery.

3. Which dietary supplement is often recommended for patients taking statins to lower cholesterol?

• A. Iron
• B. Coenzyme Q10
• C. Calcium
• D. Magnesium

Correct answer: B

Rationale: Coenzyme Q10 is often recommended for patients on statins because it may help reduce muscle pain, a common side effect of these medications. Iron (Choice A) is not typically recommended for patients taking statins to lower cholesterol. Calcium (Choice C) and Magnesium (Choice D) are not specifically indicated for addressing muscle pain associated with statin use, making them less suitable choices in this scenario.

4. Which vitamin acts most like a hormone?

• A. Vitamin A
• B. Vitamin B
• C. Vitamin D
• D. Vitamin C

Correct answer: C

Rationale: The correct answer is Vitamin D. Although vitamin D, also known as calciferol, has been called a vitamin, it is more appropriately classified as a hormone. Like hormones, vitamin D acts to control the function of other cell types. For example, it helps the body absorb and regulate skeletal calcium and phosphorus levels. Choice A (Vitamin A) plays a crucial role in vision and immune function. Choice B (Vitamin B) is a complex of different vitamins that play various roles in the body. Choice D (Vitamin C) is important for collagen production and acts as an antioxidant.

5. Which set of guidelines is intended to assess nutrient adequacy or plan intake of a population group, not individuals?

• A. RDA
• B. EAR
• C. DRA
• D. UL

Correct answer: B

Rationale: The Estimated Average Requirement (EAR) is the correct choice because it is specifically designed to assess the nutrient adequacy of population groups, not individuals. The Recommended Dietary Allowance (RDA) (choice A) is the average daily level of intake sufficient to meet the nutrient requirements of nearly all (97%-98%) healthy individuals in a particular life stage and gender group. The Dietary Reference Intake (DRI) (choice C) includes the EAR, RDA, Adequate Intake (AI), and UL, making it a broader set of nutrient reference values. The Tolerable Upper Intake Level (UL) (choice D) is the highest average daily nutrient intake level that is likely to pose no risk of adverse health effects to almost all individuals in the general population.

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