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 with frequent kidney stones is receiving dietary teaching from a nurse. Which of the following instructions should the nurse include?

• A. Limit your intake of dairy products.
• B. Increase your consumption of protein-rich foods.
• C. Avoid eating tree nuts, such as almonds.
• D. Take a vitamin C supplement twice daily.

Correct answer: A

Rationale: The correct answer is to instruct the client to limit their intake of dairy products. Dairy products are high in calcium and can contribute to kidney stone formation in susceptible individuals. Increasing protein intake may lead to higher excretion of calcium, which can exacerbate kidney stone formation. While tree nuts are high in oxalates, which can contribute to kidney stone formation, it is not the primary concern in this case. Vitamin C supplements can increase oxalate levels in the urine, potentially increasing the risk of kidney stone formation, so it should not be recommended.

3. If a person could not make bile, what would happen?

• A. experience fatigue, as the body would not be able to make lipid carriers to deliver fat to body cells for energy
• B. have less cholesterol being made by the liver
• C. need to consume higher levels of fat
• D. be unable to absorb most lipids, and fat would be excreted in the feces

Correct answer: D

Rationale: The correct answer is D. Bile is essential for emulsifying fats in the small intestine, allowing them to be absorbed. Without bile, most fats would not be absorbed and would be excreted in the feces. Choices A, B, and C are incorrect because the primary role of bile is in the digestion and absorption of fats, rather than affecting lipid carriers, cholesterol production, or dietary fat consumption.

4. What is one of the best nutritional actions a caregiver can take to help a patient with Alzheimer's disease maintain appropriate body weight?

• A. Thicken liquids to prevent choking
• B. Supervise food planning and mealtimes
• C. Assist the person in completing a grocery checklist
• D. Feed the person their meals and snacks

Correct answer: B

Rationale: The correct answer is B, 'Supervise food planning and mealtimes'. This action ensures the patient with Alzheimer's disease maintains an appropriate diet and body weight, thus reducing the risk of malnutrition. While choices A, 'Thicken liquids to prevent choking', C, 'Assist the person in completing a grocery checklist', and D, 'Feed the person their meals and snacks', might be beneficial in certain circumstances, they do not directly contribute to the maintenance of appropriate body weight as effectively as supervising food planning and mealtimes does.

5. Disposal of medical records in government hospitals/institutions must be done in close coordination with what agency?

• A. Department of Interior and Local Government (DILG)
• B. Metro Manila Development Authority (MMDA)
• C. Records Management Archives Office (RMAO)
• D. Department of Health (DOH)

Correct answer: C

Rationale: Effective nursing care involves comprehensive assessments that address all aspects of a patient's condition, ensuring that interventions are appropriately targeted and outcomes are optimized.

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