Nursing Elites

1. Which type of diet is recommended for patients with diverticulitis during an acute flare-up?

• A. High-fiber
• B. Low-residue
• C. Low-fat
• D. High-protein

Correct answer: B

Rationale: During an acute flare-up of diverticulitis, a low-residue diet is recommended. This diet helps reduce bowel movements and minimizes irritants in the colon, which can help alleviate symptoms and promote healing. High-fiber diets, like choice A, are typically recommended for diverticulosis prevention but may exacerbate symptoms during a flare-up due to increased bulk in the stool. Low-fat (choice C) and high-protein (choice D) diets are not specifically indicated for diverticulitis flare-ups.

2. The client diagnosed with thalassemia, a hereditary anemia, is to receive a transfusion of packed RBCs. The cross-match reveals the presence of antibodies that cannot be cross-matched. Which precaution should the nurse implement when initiating the transfusion?

• A. Start the transfusion at 10-15 mL per hour for 15-30 minutes
• B. Re-crossmatch the blood until the antibodies are identified
• C. Have the client sign a permit to receive uncrossmatched blood
• D. Have the unlicensed nursing assistant stay with the client

Correct answer: A

Rationale: Starting the transfusion slowly at 10-15 mL per hour for 15-30 minutes is essential when the cross-match reveals the presence of antibodies that cannot be cross-matched. This precaution allows the nurse to monitor for any adverse reactions due to the antibodies. Re-crossmatching the blood until the antibodies are identified (choice B) may delay the transfusion process and put the client at risk. Having the client sign a permit to receive uncrossmatched blood (choice C) is not a standard practice and does not address the immediate need for precautions during transfusion. Having the unlicensed nursing assistant stay with the client (choice D) is unrelated to the safe initiation of the transfusion and is not a precaution specific to managing antibodies in blood products.

3. What is the initial step in providing healthcare for a patient?

• A. Obtain and interpret vital signs
• B. Determine the needs of the patient
• C. Develop a plan of care
• D. Obtain lab work and x-rays

Correct answer: B

Rationale: The initial step in providing healthcare for a patient is to determine the needs of the patient. This step involves assessing the patient's condition, listening to their concerns, and understanding what care or treatment they require. Obtaining and interpreting vital signs (Choice A) is a crucial step but typically follows the assessment of the patient's needs. Developing a plan of care (Choice C) and obtaining lab work and x-rays (Choice D) come after understanding the patient's needs and assessing their condition.

4. The nurse is aware that norepinephrine is secreted by which endocrine gland?

• A. The pancreas
• B. The adrenal cortex
• C. The adrenal medulla
• D. The anterior pituitary gland

Correct answer: C

Rationale: Norepinephrine is indeed secreted by the adrenal medulla, making choice C the correct answer. The adrenal medulla is part of the adrenal glands, located on top of the kidneys. Norepinephrine is involved in the body's 'fight or flight' response, helping to prepare the body to react to stress. Choices A, B, and D are incorrect as norepinephrine is not secreted by the pancreas, adrenal cortex, or the anterior pituitary gland.

5. A patient with diabetes should be advised to avoid which type of carbohydrate?

• A. Simple carbohydrates
• B. Complex carbohydrates
• C. Fiber-rich carbohydrates
• D. All carbohydrates

Correct answer: A

Rationale: The correct answer is A: Simple carbohydrates. Simple carbohydrates can cause rapid spikes in blood glucose levels, which can be problematic for patients with diabetes. These carbohydrates are quickly broken down and absorbed by the body, leading to sharp increases in blood sugar levels. In contrast, complex carbohydrates and fiber-rich carbohydrates are generally better choices for individuals with diabetes because they are digested more slowly, resulting in a more gradual rise in blood glucose levels. Choice B, complex carbohydrates, are a better option for diabetic patients compared to simple carbohydrates. Choice C, fiber-rich carbohydrates, can also be beneficial for individuals with diabetes as they help in regulating blood sugar levels. Choice D, all carbohydrates, is too broad of a statement as not all carbohydrates have the same impact on blood glucose levels.

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