Nursing Elites

1. You are an ostomy nurse and you know that colostomy is defined as:

• A. It is an incision into the colon to create an artificial opening to the exterior of the abdomen
• B. It is end to end anastomosis of the gastric stump to the duodenum
• C. It is end to end anastomosis of the gastric stump to the jejunum
• D. It is an incision into the ileum to create an artificial opening to the exterior of the abdomen

Correct answer: A

Rationale: Patient safety and efficacy of care depend on actions rooted in established nursing protocols that consider both the immediate and long-term needs of the patient.

2. While evaluating the meal choices of a client with major depressive disorder and a prescription of Phenelzine, which of the following selections should the nurse identify as appropriate?

• A. Cheddar cheese
• B. Smoked salmon
• C. Strawberry yogurt
• D. Pepperoni pizza

Correct answer: C

Rationale: The correct answer is C, 'Strawberry yogurt.' This choice is appropriate because it does not contain high levels of tyramine, which can lead to a dangerous interaction with Phenelzine, a monoamine oxidase inhibitor. Tyramine-rich foods, like aged cheeses (such as cheddar cheese) and cured meats (like smoked salmon and pepperoni), should be avoided by individuals taking Phenelzine to prevent hypertensive crisis. Strawberry yogurt is a safer option for the client in this scenario.

3. Which type of lipid is solid at room temperature?

• A. Cholesterol
• B. Phospholipid
• C. Saturated fat
• D. Trans fat

Correct answer: C

Rationale: Saturated fats, such as those found in butter and lard, are typically solid at room temperature due to the lack of double bonds, which allows the fat molecules to pack closely together. Cholesterol (Choice A) is a steroid, not a fat, and while it's solid at room temperature, it doesn't fit the general category of 'lipid' in the context of this question. Phospholipids (Choice B) are a major component of all cell membranes and can be both solid and liquid at room temperature depending on their composition. Trans fats (Choice D) can also be solid or liquid at room temperature, but they are not typically referred to as 'lipids' in a general sense.

4. What type of drug is lamivudine, used for the management of HIV infection?

• A. CCR5 antagonist
• B. fusion inhibitor
• C. nucleoside reverse transcriptase inhibitor
• D. protease inhibitor

Correct answer: C

Rationale: Lamivudine belongs to the class of nucleoside reverse transcriptase inhibitors (NRTIs), making choice C the correct answer. NRTIs like lamivudine work by inhibiting the reverse transcriptase enzyme, an essential component for the HIV virus to replicate. Choices A, B, and D are incorrect because lamivudine does not function as a CCR5 antagonist, fusion inhibitor, or protease inhibitor in the management of HIV infection.

5. Can fluid retention cause lab values to be deceptively high, whereas dehydration may cause the values to be deceptively low?

• A. TRUE
• B. FALSE
• C. Not always
• D. Sometimes

Correct answer: B

Rationale: The statement is incorrect. Fluid retention generally results in lab values appearing deceptively low, not high, because the excess fluid dilutes the concentration of substances in the blood. Conversely, dehydration can make lab values appear deceptively high as the reduced fluid volume in the body means substances in the blood are less diluted. Choices 'C: Not always' and 'D: Sometimes' are not specific and do not directly address the statement in the question, hence they are incorrect.

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