Nursing Elites

1. You are to measure the client's initial blood pressure reading by doing all of the following EXCEPT:

• A. Take the blood pressure reading on both arms for comparison
• B. Listen to and identify the phases of Korotkoff sounds
• C. Pump the cuff to around 50 mmHg above the point where the pulse is obliterated
• D. Observe procedures for infection control

Correct answer: B

Rationale: When measuring blood pressure, it is crucial to follow specific steps to obtain accurate readings. Taking the blood pressure on both arms for comparison helps assess any variations. Pumping the cuff to around 50 mmHg above the point of pulse obliteration ensures accurate measurements. Observing procedures for infection control is vital to prevent the spread of infections. Listening to and identifying the phases of Korotkoff sounds are associated with auscultatory blood pressure measurements, not the initial blood pressure reading process.

2. Which set of guidelines is intended to assess nutrient adequacy or plan intake of a population group, not individuals?

• A. RDA
• B. EAR
• C. DRA
• D. UL

Correct answer: B

Rationale: The Estimated Average Requirement (EAR) is the correct choice because it is specifically designed to assess the nutrient adequacy of population groups, not individuals. The Recommended Dietary Allowance (RDA) (choice A) is the average daily level of intake sufficient to meet the nutrient requirements of nearly all (97%-98%) healthy individuals in a particular life stage and gender group. The Dietary Reference Intake (DRI) (choice C) includes the EAR, RDA, Adequate Intake (AI), and UL, making it a broader set of nutrient reference values. The Tolerable Upper Intake Level (UL) (choice D) is the highest average daily nutrient intake level that is likely to pose no risk of adverse health effects to almost all individuals in the general population.

3. Medication for treating high blood cholesterol levels should not be used for most people unless:

• A. The patient has at least three major risk factors for coronary heart disease
• B. The patient has been experiencing symptoms of coronary heart disease for at least three months
• C. The patient's medical insurance covers prescription drugs
• D. Treatment with Therapeutic Lifestyle Changes (TLC) alone is unsuccessful after three months

Correct answer: D

Rationale: The correct answer is choice D because medication for high cholesterol is typically not considered unless Therapeutic Lifestyle Changes (TLC), which include diet and exercise, have not proven effective after a three-month period. This approach ensures that lifestyle modifications are given a fair chance to lower cholesterol levels before resorting to medication. Choice A is incorrect because the number of risk factors for coronary heart disease does not dictate when to begin medication; it is about the effectiveness of lifestyle changes. Choice B is incorrect as the duration of coronary heart disease symptoms does not determine when to start medication; the focus is on the response to TLC. Choice C is incorrect because the coverage of prescription drugs by the patient's insurance does not influence the medical decision to use medication for high cholesterol; it is based on medical necessity and effectiveness of prior interventions.

4. A client is being taught by a nurse about adding more fiber to the diet. Which of the following foods has the highest fiber content?

• A. 1 cup cooked sweet potato
• B. 1 slice rye toast
• C. 1 cup raw watermelon
• D. 1 oz cashews

Correct answer: D

Rationale: The correct answer is D, 1 oz of cashews. Cashews have a higher fiber content compared to sweet potato, rye toast, and watermelon. While sweet potatoes and rye toast contain fiber, cashews have a higher concentration, making them a better choice for increasing fiber intake. Watermelon, on the other hand, is low in fiber compared to the other options provided.

5. What is the best snack choice for a preschool-age child?

• A. Fruit snacks
• B. Mini wheat bagel with peanut butter
• C. White toast with jelly
• D. Sports drink

Correct answer: B

Rationale: The best snack choice for a preschool-age child is a mini wheat bagel with peanut butter as it provides a good balance of carbohydrates, protein, and healthy fats. Fruit snacks, although they contain some fruit flavor, are often high in added sugars and lack essential nutrients. White toast with jelly may provide quick energy but lacks protein and healthy fats, which are important for a balanced snack choice. Sports drinks are typically high in sugar and unnecessary for a preschool-age child's snack, as they are designed for rehydration during intense physical activity, not as a regular snack option.

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