Nursing Elites

1. You are caring for an infant who is just about 12 months old. Which assessment data is normal for the infant at this age?

• A. The infant had doubled their birth weight at twelve months.
• B. The infant had tripled their birth weight at twelve months.
• C. The mother reports that the infant is drinking 60 mLs per kilogram of its body weight.
• D. The infant had grown � inch since last month.

Correct answer: A

Rationale: The normal assessment data for the infant at 12 months of age is that the infant has doubled their birth weight at 12 months of age. The mother's reports that the infant is drinking 60 mLs per kilogram of its body weight and the fact that the infant had grown � inch since last month are not normal assessment data. Infants are fed breast milk or formula every two to four hours with a total daily intake of 80 to 100 mLs per kilogram of body weight. As the neonate grows, they gain five to seven ounces during the first six months and then they double their birth weight during the first year; the head circumference increases a half inch each month for six months and then two tenths of an inch until the infant is one year of age. Similarly, the height or length of the newborn increases an inch a month for the first 6 months and then 1/2 inch a month until the infant is 1 year of age.

2. When teaching a client with coronary artery disease about nutrition, what should the nurse emphasize?

• A. Eating three balanced meals a day
• B. Adding complex carbohydrates
• C. Avoiding very heavy meals
• D. Limiting sodium intake to 7 g per day

Correct answer: C

Rationale: The correct answer is to emphasize avoiding very heavy meals. Eating large, heavy meals can divert blood away from the heart for digestion, potentially endangering clients with coronary artery disease. This practice may lead to an increased risk of plaque accumulation in the arteries, potentially obstructing the delivery of blood and oxygen to vital organs. Choices A, B, and D are incorrect. While eating three balanced meals a day, adding complex carbohydrates, and limiting sodium intake are generally good dietary practices, they are not the primary focus when teaching a client with coronary artery disease about nutrition. The emphasis should be on avoiding heavy meals that can strain the cardiovascular system.

3. A client is receiving education on cholesterol. Which of the following statements from the client indicates the need for further teaching?

• A. I would like my HDL levels to be over 50.
• B. It is better for me to have high HDL levels and low LDL levels.
• C. It is better for me to have high LDL levels and low HDL levels.
• D. My goal is to get my total cholesterol below 200.

Correct answer: C

Rationale: The correct answer is, 'It is better for me to have high LDL levels and low HDL levels.' This statement indicates a need for further teaching because high LDL levels contribute to atherosclerosis, while high HDL levels can protect against heart disease. The client should understand the importance of lowering LDL levels and increasing HDL levels to maintain good heart health. Choice A is correct as desiring HDL levels over 50 is a positive goal. Choice B is correct as it reflects the ideal scenario of high HDL and low LDL levels. Choice D is correct as a total cholesterol below 200 is a common goal for heart health. Therefore, Choice C is incorrect as it suggests an opposite and unhealthy relationship between LDL and HDL levels.

4. Choose the BEST answer. To ensure adequate protection for legal issues, offices should maintain patients' charts for:

• A. 10 years
• B. Forever
• C. Until the age of majority
• D. 2 years after the patient was last seen in the office

Correct answer: B

Rationale: The correct answer is 'Forever.' Maintaining patients' charts indefinitely ensures comprehensive legal protection by having all relevant information available in case of litigation or if patient history needs to be referenced in the future. Choice A, '10 years,' may not be sufficient to cover the entire period within which legal issues may arise. Choice C, 'Until the age of majority,' is not ideal as legal matters may extend beyond this age limit. Choice D, '2 years after the patient was last seen in the office,' is inadequate as legal actions can occur beyond this timeframe, necessitating the need for long-term retention of patient charts.

5. Working in a clinic located in a community with many Hispanics, what strategy could the nurse implement to decrease health care disparities for Hispanic patients?

• A. Improve public transportation to the clinic.
• B. Update equipment and supplies at the clinic.
• C. Obtain low-cost medications for clinic patients.
• D. Teach clinic staff about Hispanic health beliefs.

Correct answer: D

Rationale: Health care disparities are primarily rooted in stereotyping, biases, and prejudice among healthcare providers. By educating clinic staff about Hispanic health beliefs, the nurse can help combat these issues, leading to improved cultural competency and patient care. Understanding the cultural context of Hispanic patients can enhance communication, trust, and treatment adherence. Improving public transportation, updating equipment, and obtaining low-cost medications are important aspects of healthcare delivery but do not directly address the underlying causes of health disparities experienced by Hispanic patients.

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