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. If the child does not have ear problem, using IMCI, what should you as the nurse do?

• A. Check for ear discharge
• B. Check for tender swellings behind the ear
• C. Check for ear pain
• D. Go to the next question, check for malnutrition

Correct answer: A

Rationale: Patient safety and efficacy of care depend on actions rooted in established nursing protocols that consider both the immediate and long-term needs of the patient.

3. Each statement accurately describes the physical effects of food on periodontal health, except one. Which is the exception?

• A. Supragingival plaque biofilm adhesion is influenced by frequent consumption of monosaccharides
• B. Supragingival plaque biofilm adhesion is influenced by frequent consumption of disaccharides
• C. Poor nutrition has an adverse effect on the periodontium
• D. Chewing soft, spongy foods stimulates salivary flow

Correct answer: D

Rationale: The correct answer is D. Chewing soft, spongy foods does not stimulate salivary flow; rather, firm, fibrous foods like fruits and vegetables do. Soft foods can stick to teeth, promoting plaque buildup. Choices A, B, and C are accurate: Supragingival plaque biofilm adhesion is influenced by both monosaccharides and disaccharides, while poor nutrition can indeed have adverse effects on the periodontium.

4. During blood administration, what is essential for the nurse to do in order to carefully monitor for adverse reactions?

• A. Stay with the client for the first 15 minutes of blood administration
• B. Stay with the client for the entire period of blood administration
• C. Run the infusion at a faster rate during the first 15 minutes
• D. Inform the client to notify the staff immediately for any adverse reaction

Correct answer: A

Rationale: In the context of blood administration, it's crucial for the nurse to stay with the client for the first 15 minutes. This is because most adverse reactions are likely to occur within this initial period. Monitoring the client closely during this time allows for immediate detection and response to any potential reactions. Choice B, staying with the client for the entire period of blood administration, is not typically feasible or necessary, although regular checks should be conducted. Running the infusion at a faster rate during the first 15 minutes (Choice C) is incorrect as this can actually increase the risk of adverse reactions. Informing the client to notify the staff immediately for any adverse reaction (Choice D) is an important practice, but it is not the most direct way for the nurse to monitor for adverse reactions.

5. Which vitamin deficiency is most likely to be associated with increased risk of macular degeneration?

• A. Vitamin A
• B. Vitamin B12
• C. Vitamin C
• D. Vitamin E

Correct answer: D

Rationale: Vitamin E is an antioxidant that helps protect eye health and prevent macular degeneration.

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