Nursing Elites

1. Which of the following terms refers to a process by which an individual receives education about the recognition of stress reactions and management strategies for handling stress, which may be instituted after a disaster?

• A. Critical incident stress management
• B. Follow-up
• C. Debriefing
• D. Defusion

Correct answer: A

Rationale: Critical incident stress management is a process that provides individuals with education about recognizing stress reactions and strategizing management techniques for handling stress after a disaster. Choice B, 'Follow-up', is incorrect because it generally refers to continuing care after initial treatment, not specifically to stress management education. Choice C, 'Debriefing', is a process where individuals involved in a critical event are brought together to discuss the event and their reactions to it. It can be part of the critical incident stress management process, but it doesn't cover the whole process. Choice D, 'Defusion', is a technique used in the immediate aftermath of a traumatic event to help individuals process their experiences, but it does not encompass the full range of education about stress recognition and management strategies.

2. What is the glomerular filtration rate for patients with stage 5 chronic kidney disease (CKD)?

• A. Less than 15 mL/min/1.73 m�
• B. Less than 30 mL/min/1.73 m�
• C. Less than 90 mL/min/1.73 m�
• D. Less than 125 mL/min/1.73 m�

Correct answer: A

Rationale: In patients with stage 5 chronic kidney disease (CKD), also known as end-stage renal disease, the kidney function is significantly compromised. This severe condition is characterized by a glomerular filtration rate (GFR) of less than 15 mL/min/1.73 m�, as correctly stated in choice A. Choices B, C, and D suggest higher GFR values, which are not indicative of stage 5 CKD. Specifically, a GFR of less than 30 mL/min/1.73 m� indicates stage 4 CKD, less than 90 mL/min/1.73 m� signifies stage 3 CKD, and a typical healthy individual usually has a GFR of around 125 mL/min/1.73 m�, which is far above the GFR for stage 5 CKD.

3. Are the following statements both true: 'Most excess energy intake, whether from protein, carbohydrate, alcohol, or fat, is stored in the liver' and 'Fat is a good source of energy, but the preferred fuel is protein'?

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

Correct answer: B

Rationale: Both of the given statements are false. The first statement is inaccurate because the primary location for excess energy storage is not the liver, but rather adipose tissue where it is stored as fat. While the liver does have a role in energy storage and metabolism, it is not the main storage site for excess intake. The second statement is also incorrect. Although fat and protein can be used as sources of energy, the body's preferred source of energy is carbohydrates. They break down more efficiently and are easier for the body to use. The body prefers to conserve protein for other essential functions, such as tissue repair and the production of enzymes. Therefore, protein is not the preferred fuel source.

4. A client who has chronic lymphocytic leukemia is starting chemotherapy treatments and asks if she needs to make any dietary changes. Which of the following statements should the nurse make?

• A. "You should avoid drinking liquids an hour before the treatments."?
• B. "Eating low-calorie foods helps prevent nausea."?
• C. "Foods that are higher in fat are usually more appealing."?
• D. "Raw fruits and vegetables will be easier for your body to digest."?

Correct answer: D

Rationale: During chemotherapy treatments for chronic lymphocytic leukemia, raw fruits and vegetables are recommended as they are easier for the body to digest. This choice provides essential nutrients and is gentle on the digestive system. Option A is incorrect because staying hydrated is crucial during chemotherapy. Option B is incorrect as low-calorie foods may not provide sufficient energy during treatment. Option C is incorrect because high-fat foods are not typically recommended due to potential digestive issues.

5. A client who is experiencing dumping syndrome following gastric surgery is receiving education from a nurse. Which of the following statements by the client indicates an understanding of the teaching?

• A. I should drink additional fluids with my meals.
• B. I should eat high-fiber snacks between meals.
• C. I should eat a protein source with each meal.
• D. I can have caffeinated beverages in small amounts.

Correct answer: C

Rationale: The correct answer is C. Eating a protein source with each meal can help manage dumping syndrome by slowing gastric emptying and reducing symptoms. This choice is the most appropriate as it directly addresses a key dietary recommendation for dumping syndrome. Choices A, B, and D are incorrect because drinking additional fluids with meals, eating high-fiber snacks between meals, and consuming caffeinated beverages can exacerbate dumping syndrome symptoms by increasing gastric emptying and worsening the condition.

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