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. 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.

3. A patient is being discharged with a vitamin K deficiency. What food should the nurse recommend to the patient to include in their diet?

• A. Oranges
• B. Spinach
• C. Fish
• D. Nuts

Correct answer: B

Rationale: Spinach is an excellent source of vitamin K, which plays a vital role in blood clotting and bone health. Oranges, fish, and nuts do not contain significant amounts of vitamin K, making them less suitable choices to address a vitamin K deficiency. Therefore, the correct recommendation for a patient with a vitamin K deficiency would be to include spinach in their diet to help replenish this essential vitamin.

4. After cleaning the abrasions and applying antiseptic, the nurse applies a cold compress to the swollen ankle as ordered by the physician. This statement shows that the nurse has a correct understanding of the use of a cold compress:

• A. Cold compress reduces blood viscosity in the affected area
• B. It is safer to apply than a hot compress
• C. Cold compress prevents edema and reduces pain
• D. It eliminates toxic waste products due to vasodilation

Correct answer: C

Rationale: The correct understanding of using a cold compress includes knowing that it helps prevent edema and reduces pain. Cold application constricts blood vessels, reducing blood flow to the area, which helps decrease swelling and pain. Choices A, B, and D are incorrect because cold compresses do not directly affect blood viscosity, safety compared to hot compresses, or eliminate toxic waste products due to vasodilation. It is essential for nurses to have a clear understanding of the rationale behind interventions to provide effective patient care.

5. When assessing Richard for chest percussion or chest vibration and postural drainage, Mario would focus on the following EXCEPT:

• A. Amount of food and fluid taken during the last meal before treatment
• B. Respiratory rate, breath sounds, and location of congestion
• C. Teaching the client's relatives to perform the procedure
• D. Doctor's order regarding position restrictions and client's tolerance for lying flat

Correct answer: B

Rationale: The correct answer is B because when assessing Richard for chest percussion or chest vibration and postural drainage, Mario would focus on various aspects such as the amount of food and fluid taken before treatment to prevent complications during the procedure, teaching the client's relatives to perform the procedure correctly, and following the doctor's orders regarding position restrictions and the client's tolerance for lying flat. Respiratory rate, breath sounds, and location of congestion would be assessed during the procedure itself, not as part of the pre-assessment.

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