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. Fires are approached using the mnemonic RACE, in which, R stands for:

• A. Run
• B. Race
• C. Rescue
• D. Remove

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.

3. Patients with congestive heart failure need to restrict their intake of:

• A. fiber
• B. sodium
• C. cholesterol
• D. saturated fat

Correct answer: B

Rationale: Patients with congestive heart failure need to restrict their intake of sodium. This restriction is crucial to prevent fluid retention, which can exacerbate the condition. While fiber is generally beneficial for heart health, sodium restriction is more critical in this scenario. Cholesterol and saturated fat intake should also be monitored, but sodium restriction takes precedence due to its direct impact on fluid balance.

4. Each statement accurately describes the physical effects of food on periodontal health, except one. Which is the exception?

• A. Supragingival plaque biofilm adhesion is influenced by frequent consumption of monosaccharides
• B. Supragingival plaque biofilm adhesion is influenced by frequent consumption of disaccharides
• C. Poor nutrition has an adverse effect on the periodontium
• D. Chewing soft, spongy foods stimulates salivary flow

Correct answer: D

Rationale: The correct answer is D. Chewing soft, spongy foods does not stimulate salivary flow; rather, firm, fibrous foods like fruits and vegetables do. Soft foods can stick to teeth, promoting plaque buildup. Choices A, B, and C are accurate: Supragingival plaque biofilm adhesion is influenced by both monosaccharides and disaccharides, while poor nutrition can indeed have adverse effects on the periodontium.

5. A nurse is caring for a client following a CVA and observes the client experiencing severe dysphagia. The nurse notifies the provider. Which of the following nutritional therapies will likely be prescribed?

• A. NPO until dysphagia subsides
• B. Supplements via nasogastric tube
• C. Initiation of total parenteral nutrition
• D. Soft residue diet

Correct answer: B

Rationale: In the scenario of severe dysphagia following a CVA, the client may have difficulty swallowing and require alternative nutritional support. Providing supplements via a nasogastric tube allows for the delivery of essential nutrients directly into the stomach, bypassing the swallowing difficulties. NPO (nothing by mouth) until dysphagia subsides may be too restrictive for the client's nutritional needs. Initiation of total parenteral nutrition is usually reserved for cases where enteral feeding is not possible or contraindicated. A soft residue diet may not be suitable for a client experiencing severe dysphagia.

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