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 is being cared for by a nurse who has stomatitis following radiation treatment. Which of the following is an appropriate intervention for the nurse to take?

• A. Serve foods without sauces or gravies
• B. Offer mouth rinses with normal saline and water
• C. Serve foods while still at a hot temperature
• D. Instruct the client to drink liquids without a straw

Correct answer: B

Rationale: Offering mouth rinses with normal saline and water is an appropriate intervention for a nurse caring for a patient with stomatitis following radiation treatment. This intervention can help soothe and clean the mouth, promoting comfort and oral hygiene. Choice A is incorrect because serving foods without sauces or gravies does not directly address the client's stomatitis. Choice C is incorrect because serving hot foods can exacerbate discomfort in the client's mouth. Choice D is incorrect because using a straw can help in preventing further irritation in the client's mouth.

3. A nurse is caring for a client who is lactose intolerant. Which of the following clinical manifestations should the nurse assess?

• A. Fever
• B. Blood in stools
• C. Cramping
• D. Steatorrhea

Correct answer: C

Rationale: The correct answer is C: Cramping. Cramping is a common clinical manifestation of lactose intolerance due to the inability to digest lactose properly. Fever (choice A) is not typically associated with lactose intolerance. Blood in stools (choice B) is more indicative of other gastrointestinal issues like inflammatory bowel disease. Steatorrhea (choice D) is the presence of excess fat in the stool and is not a typical symptom of lactose intolerance.

4. During times of staff and financial shortage, which method is the best and most effective?

• A. Functional Method
• B. Primary Nursing
• C. Team Nursing
• D. Modular Method

Correct answer: D

Rationale: During times of staff and financial shortage, the Modular Method is considered the best and most effective. This method allows for flexibility and adaptability in assigning tasks and responsibilities, making it easier to cope with limited resources. Functional Method (Choice A) focuses on the division of labor based on each staff member's skills, which may not be the most efficient during shortages. Primary Nursing (Choice B) and Team Nursing (Choice C) may require a more significant number of staff, making them less suitable during shortages.

5. Each is a physiologic role of vitamin D, except one. Which is the exception?

• A. Hematopoiesis
• B. Cardiac and neuromuscular function
• C. Immune responses
• D. Serum calcium regulation

Correct answer: A

Rationale: The correct answer is A, Hematopoiesis. Vitamin D plays a crucial role in regulating serum calcium levels, which is essential for maintaining cardiac and neuromuscular function. Additionally, vitamin D is involved in modulating immune responses. However, hematopoiesis, the formation of red blood cells, is not a direct physiologic role of vitamin D. Therefore, hematopoiesis is the exception among the listed functions of vitamin D.

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