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 Crohn's disease is being cared for by a nurse. Which of the following food choices aligns with the recommended diet for clients with Crohn's disease?

• A. Vanilla milkshake
• B. Buttered popcorn
• C. Tossed green salad
• D. Toast with jelly

Correct answer: C

Rationale: The correct answer is a 'Tossed green salad.' Clients with Crohn's disease often benefit from a low-residue diet, which includes easily digestible foods like leafy green vegetables found in a tossed green salad. This type of diet helps minimize gastrointestinal symptoms. Choices A, B, and D are not ideal for clients with Crohn's disease. Vanilla milkshake, buttered popcorn, and toast with jelly may exacerbate symptoms due to their high fat, fiber, or sugar content, which can be harder to digest.

3. Lynn is an older adult who lives alone and has requested advice on how to eat a nutritious diet as cheaply as possible. One useful, practical tip for Lynn might be to _____.

• A. buy just a few pieces of fresh fruit at a time, in different stages of ripeness
• B. choose small boxes of frozen vegetables instead of large bags
• C. purchase pre-sliced or shredded cheese rather than whole pieces
• D. avoid buying certain foods in bulk, such as beans or dried legumes

Correct answer: A

Rationale: Buying a few pieces of fresh fruit at different stages of ripeness ensures that Lynn will have ripe fruit available over several days, reducing waste and cost. Choice B focuses on frozen vegetables but doesn't address the variety and ripeness factor like Choice A. Choice C is about cheese, which may not be as essential for a nutritious diet compared to fresh fruit. Choice D suggests avoiding certain foods in bulk, which might not be as relevant for maintaining a nutritious diet economically as the strategy in Choice A.

4. What would a diet manual most likely contain?

• A. Procedures for disinfecting cooking surfaces
• B. Staff sanitation guidelines
• C. Information on specific patients' resting metabolic rates
• D. Specific food preparation methods

Correct answer: D

Rationale: A diet manual typically contains guidance on specific food preparation methods to ensure proper nutrition and health for individuals following the diet. Therefore, choice D is correct. Choices A and B refer to sanitation procedures and staff hygiene issues, which are important but not typically the focus of a diet manual. Choice C, regarding specific patients' resting metabolic rates, is too individualized and detailed for a general diet manual, as it would be part of a personalized dietary plan developed with a healthcare professional.

5. A healthcare provider is providing teaching about nutrition to a group of clients. The healthcare provider should include that which of the following foods contains the highest level of thiamine per serving?

• A. 1 hard-boiled egg
• B. 1 cup dried pears
• C. 1 cup whole grain wheat flour
• D. 1 cup Brussels sprouts

Correct answer: C

Rationale: Whole grain wheat flour contains the highest level of thiamine per serving compared to the other options provided. Thiamine, also known as Vitamin B1, is essential for energy metabolism. While eggs, dried pears, and Brussels sprouts are nutritious foods, they do not contain as high a level of thiamine as whole grain wheat flour. Therefore, the correct choice is whole grain wheat flour in this case.

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