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. Mrs. Pichay who is for thoracentesis is assigned by the nurse to any of the following positions, EXCEPT:

• A. straddling a chair with arms and head resting on the back of the chair
• B. lying on the unaffected side with the bed elevated 30-40 degrees
• C. lying prone with the head of the bed lowered 15-30 degrees
• D. sitting on the edge of the bed with her feet supported and arms and head on a padded overhead table

Correct answer: D

Rationale: Understanding the underlying pathology and therapeutic techniques ensures that nursing care is not only reactive but also preventative, reducing the risk of complications.

3. For a client with a history of gout, which food should be included in their diet?

• A. Red meat
• B. Whole grains
• C. High-fat dairy
• D. Processed meats

Correct answer: B

Rationale: Whole grains are low in purines and are a better choice for someone with gout.

4. Which nutrient is most important for wound healing in a patient post-surgery?

• A. Vitamin C
• B. Protein
• C. Iron
• D. Calcium

Correct answer: B

Rationale: Protein is essential for tissue repair and wound healing.

5. When rickets occurs, how is the alveolar bone affected compared to other bones in the body?

• A. Both statements are true.
• B. Both statements are false.
• C. The first statement is true; the second is false.
• D. The first statement is false; the second is true.

Correct answer: A

Rationale: Both statements are true. When rickets occurs, the alveolar bone is affected similar to other bones in the body, with the trabeculae of the alveolar bone also weakening. In addition to damaged alveolar bone caused by vitamin D deficiency, dental changes include delayed dentition and small molars. The other choices are incorrect because both statements provided are accurate based on the effects of rickets on the alveolar bone.

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