Nursing Elites

1. You are taking care of critically ill client and the doctor in charge calls to order a DNR (do not resuscitate) for the client. Which of the following is the appropriate action when getting DNR order over the phone?

• A. Have the registered nurse, family spokesperson, nurse supervisor and doctor sign
• B. Have 2 nurse validate the phone order, both nurses sign the order and the doctor should sign his order within 24
• C. Have the registered nurse, family and doctor sign the order
• D. Have 1 nurse take the order and sign it and have the doctor sign it within 24 hours

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. What is the most likely demonstration of cardiac cachexia?

• A. Decreased physical activity
• B. Weight loss and tissue wasting
• C. Poor urine output and tissue edema
• D. Cardiac arrhythmia and wet lung sounds

Correct answer: B

Rationale: Cardiac cachexia is a condition characterized by severe weight loss and tissue wasting. This typically occurs in patients suffering from heart failure due to an increased energy expenditure and reduced appetite, which is why choice B is the correct answer. The other choices are incorrect as they do not accurately describe the symptoms of cardiac cachexia. Decreased physical activity (choice A) can be a result of many conditions, not specifically cardiac cachexia. Poor urine output and tissue edema (choice C) are more indicative of kidney problems rather than cardiac cachexia. Finally, cardiac arrhythmia and wet lung sounds (choice D) are symptoms related to other cardiac conditions, not specifically to cardiac cachexia.

3. Who most often prescribes a patient's diet order?

• A. Registered Nurse
• B. Physician
• C. Registered Dietetic Technician
• D. Occupational Therapist

Correct answer: B

Rationale: A patient's dietary order is most frequently prescribed by a physician. This is because the physician has a comprehensive understanding of the patient's medical condition and can thus determine the most suitable dietary plan. Registered dietitians often collaborate with physicians in this process, but the final prescription is made by the physician. Although registered nurses, dietetic technicians, and occupational therapists play significant roles in patient care, they typically do not prescribe diet orders.

4. Name 4 of the 12 discussed groups at risk for nutritional deficiencies.

• A. Elderly
• B. Low income
• C. Vegans
• D. Chronic disease, alcoholics

Correct answer: A

Rationale: The correct answer is A: Elderly. The other choices provided, low income, vegans, and chronic disease, alcoholics, are also at risk for nutritional deficiencies but the question specifically asks for 4 groups out of the 12 discussed. The 12 groups at risk for nutritional deficiencies include the elderly, low income individuals, vegans, chronic disease, alcoholics, smokers, periods of growth, individuals with medical conditions, physical stress, physiological stress, those on polypharmacy, and those with inadequate intake. The question focuses on identifying 4 out of these 12 groups, making 'Elderly' the correct choice.

5. Which type of immunity is demonstrated by the transfer of a mother's immunoglobulin across the placenta to protect the child?

• A. Natural active immunity
• B. Natural passive immunity
• C. Artificial active immunity
• D. Artificial passive immunity

Correct answer: B

Rationale: The immunoglobulin passed from the mother to the child through the placenta is an example of natural passive immunity, making choice B the correct answer. This transfer gives the child temporary immunity to various diseases without their immune system having to work. On the other hand, natural active immunity (Choice A) occurs when the body produces its own antibodies in response to an antigen. Artificial active immunity (Choice C) is achieved through vaccinations, where the immune system is stimulated to produce antibodies against a specific disease. Artificial passive immunity (Choice D) is a temporary immunity that involves the transfer of pre-formed antibodies from another source.

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