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. What best describes a task of the registered dietitian?

• A. administering total parenteral nutrition
• B. administering formula through feeding tubes
• C. prescribing diet orders
• D. conducting nutrition assessments

Correct answer: D

Rationale: The correct answer is D, conducting nutrition assessments. Registered dietitians are responsible for assessing an individual's nutritional status, dietary intake, and health needs. This assessment forms the basis for developing personalized nutrition care plans. Choices A and B involve the administration of specialized nutrition support, which is typically done by healthcare providers with specific training in those areas. Choice C, prescribing diet orders, may fall outside the scope of practice for a dietitian as they focus more on assessment, education, and counseling related to nutrition rather than prescribing medical treatments.

3. Nurse DMLM is correct in identifying the correct sequence of events during abdominal assessment if she identifies which of the following?

• A. Inspection, Auscultation, Percussion, Palpation
• B. Inspection, Percussion, Palpation, Auscultation
• C. Inspection, Palpation, Percussion, Auscultation
• D. Inspection, Auscultation, Palpation, Percussion

Correct answer: D

Rationale: The correct sequence for abdominal assessment is Inspection, Auscultation, Percussion, Palpation. Start with Inspection to observe any visible abnormalities, followed by Auscultation to listen for bowel sounds, then Percussion to assess the density of underlying structures, and finally Palpation to feel for any tenderness or masses. Choices A, B, and C have the incorrect sequence of assessment techniques.

4. Which change during pregnancy is related to the slowing of the gastrointestinal tract?

• A. Diarrhea
• B. Constipation
• C. Decreased absorption of iron
• D. Decreased absorption of calcium

Correct answer: B

Rationale: During pregnancy, the gastrointestinal tract tends to slow down, leading to constipation. This is due to hormonal changes that relax the intestinal muscles, allowing more time for nutrient absorption and ultimately leading to constipation. Diarrhea is not typically associated with the slowing of the gastrointestinal tract during pregnancy. Decreased absorption of iron and calcium may occur during pregnancy due to increased demands, but they are not directly related to the slowing of the gastrointestinal tract.

5. In the hospital, when you need the medical record of a discharged patient for research you will request permission through:

• A. Doctor in charge
• B. The hospital director
• C. The nursing service
• D. Medical records section

Correct answer: C

Rationale: Effective nursing care involves comprehensive assessments that address all aspects of a patient's condition, ensuring that interventions are appropriately targeted and outcomes are optimized.

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