Nursing Elites

1. A nurse is providing teaching to a client with gastroesophageal reflux. Which of the following statements by the client indicates a need for further teaching?

• A. I should elevate the head of my bed while sleeping.
• B. I drink no more than 4 cups of coffee a day.
• C. I take my time when I am eating.
• D. I avoid foods and drinks made with chocolate.

Correct answer: B

Rationale: The correct answer is B: 'I drink no more than 4 cups of coffee a day.' Excessive coffee consumption can aggravate gastroesophageal reflux due to its acidic nature. Choices A, C, and D are all appropriate self-care measures for managing gastroesophageal reflux. Elevating the head of the bed while sleeping helps prevent acid reflux, eating slowly can reduce reflux episodes, and avoiding trigger foods like chocolate can help alleviate symptoms.

2. Which of the following suggestions is the healthiest for Miguel, who is always hungry and never seems to feel full despite eating enough calories?

• A. Switch out energy-dense foods with more nutrient-dense foods that are more likely to make him feel full
• B. Drink adequate amounts of water
• C. A, B
• D. Eat foods with more fat, as fat slows gastric emptying and will make him feel more full

Correct answer: C

Rationale: The correct answer is A and B. Switching to more nutrient-dense foods can help Miguel feel full despite eating enough calories. Nutrient-dense foods provide essential nutrients and are more satisfying. Drinking adequate water is also crucial for overall health and can help with feelings of fullness. Choice D is incorrect because while fat can contribute to satiety, it should be consumed in balance with other nutrients. Consuming foods with high fat content excessively may lead to other health issues and does not address the underlying problem of feeling constantly hungry despite eating.

3. A nurse is caring for a client who is well-hydrated and who demonstrates no evidence of anemia. Which of the following laboratory values gives the nurse an assessment of the adequacy of the client's protein uptake and synthesis?

• A. Albumin
• B. Calcium
• C. Sodium
• D. Potassium

Correct answer: A

Rationale: The correct answer is Albumin. Albumin is a protein made by the liver and is a key indicator of the body's protein status. Low levels of albumin can indicate inadequate protein intake or synthesis. Choices B, C, and D (Calcium, Sodium, and Potassium) are not direct indicators of protein uptake and synthesis. Calcium is related to bone health, Sodium to fluid balance, and Potassium to nerve and muscle function.

4. What are sheets/forms that provide an efficient and time-saving way to record information that must be obtained repeatedly at regular and/or short intervals of time? This does not replace progress notes; instead, it records information on vital signs, intake and output, treatment, postoperative care, postpartum care, and diabetic regimen, etc. These are used whenever specific measurements or observations need to be documented repeatedly. What is this?

• A. Nursing Kardex
• B. Graphic Flow Sheets
• C. Discharge Summary
• D. Medicine and Treatment Record

Correct answer: A

Rationale: The correct answer is A, Nursing Kardex. Nursing Kardex is a tool used for documenting essential patient information that needs to be recorded repeatedly at regular intervals. It includes vital signs, intake and output, treatment details, postoperative care, postpartum care, and diabetic regimen. This tool is efficient and time-saving for healthcare professionals. Choice B, Graphic Flow Sheets, may be used for visual representation of patient data but is not specifically designed for repeated documentation of essential information. Choice C, Discharge Summary, is a document outlining the patient's care and condition at the time of discharge, not for repeated recording of ongoing data. Choice D, Medicine and Treatment Record, focuses more on specific medications and treatments rather than a comprehensive recording of various patient data needed at regular intervals.

5. Which of the following is the most important risk factor for development of Chronic Obstructive Pulmonary Disease?

• A. Cigarette smoking
• B. Occupational exposure
• C. Air pollution
• D. Genetic abnormalities

Correct answer: B

Rationale: Nursing interventions should be grounded in a deep understanding of the physiological processes involved, ensuring that care provided is both effective and efficient.

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