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 patient on a low-sodium diet should avoid which of the following foods?

• A. Fresh fruits
• B. Unsalted nuts
• C. Canned soup
• D. Plain rice

Correct answer: C

Rationale: Canned soup is the correct answer. Canned soups are often high in sodium due to added salt and should be avoided on a low-sodium diet. Fresh fruits (Choice A) are typically low in sodium and a good choice for a low-sodium diet. Unsalted nuts (Choice B) are also low in sodium and can be included in a low-sodium diet. Plain rice (Choice D) is a low-sodium food and can be part of a low-sodium diet.

3. Why is there an ethical dilemma?

• A. Because the law does not clearly state what is right from what is wrong
• B. Because morality is subjective and it differs from each individual
• C. Because the patient's right coincide with the nurse's responsibility
• D. Because the nurse lacks ethical knowledge to determine what action is correct and what action is unethical

Correct answer: C

Rationale: The correct answer is C because an ethical dilemma arises when the patient's rights conflict with the nurse's responsibilities, requiring a careful balance to ensure ethical care delivery. Choices A and B are incorrect because ethical dilemmas are not solely about legal or subjective moral issues. Choice D is incorrect as nurses are generally equipped with ethical knowledge through education and training, and ethical dilemmas are more about conflicting values and responsibilities rather than a lack of knowledge.

4. All of the following are instructions for proper foot care to be given to a client with peripheral vascular disease caused by diabetes. Which one is not?

• A. Trim nails using a nail clipper
• B. Apply cornstarch to the foot
• C. Always check the temperature of the water before bathing
• D. Use canvas shoes

Correct answer: A

Rationale: The correct answer is 'A', which says trim nails using a nail clipper. This is incorrect because patients with peripheral vascular disease, particularly those caused by diabetes, should not trim their nails themselves due to the risk of injury, infection, and poor wound healing. The other options, 'B', 'C', and 'D', are correct advice for diabetic foot care. Applying cornstarch can help keep the feet dry and prevent fungal infections. Checking the water temperature before bathing can prevent burns, as patients with peripheral vascular disease often have decreased sensation in their feet. Wearing canvas shoes can improve foot ventilation and reduce the risk of foot ulcers and infections.

5. What is the fundamental difference between nursing diagnoses and collaborative problems?

• A. Collaborative problems are managed by nurses using physician-prescribed interventions.
• B. Collaborative problems can be addressed by independent nursing interventions.
• C. Physician-prescribed interventions are incorporated into nursing diagnoses.
• D. Nursing diagnoses include physiologic complications that nurses monitor to detect status changes.

Correct answer: B

Rationale: The correct answer is B, as collaborative problems necessitate the collective expertise and skills of numerous healthcare professionals, including nurses. These problems can be dealt with through independent nursing interventions in cooperation with other team members. Option A is incorrect because collaborative problems aren't strictly managed with physician-prescribed interventions. Option C is incorrect because nursing diagnoses aim at identifying and treating actual or potential health issues, rather than merely integrating physician-prescribed interventions. Option D is incorrect because nursing diagnoses aim at identifying patient issues, not solely physiologic complications, and guide the necessary nursing care, not just monitor for changes.

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