Nursing Elites

1. _____ neutralizes stomach acid in the small intestine:

• A. saliva
• B. gastric mucus
• C. bicarbonate ions
• D. enzymes

Correct answer: C

Rationale: The correct answer is C: bicarbonate ions. Bicarbonate ions, secreted by the pancreas, neutralize the acidic chyme entering the small intestine from the stomach, creating a more suitable environment for digestive enzymes. Saliva (choice A) helps in the initial breakdown of food in the mouth, not in neutralizing stomach acid. Gastric mucus (choice B) protects the stomach lining from the acidic environment but does not neutralize the acid in the small intestine. Enzymes (choice D) facilitate chemical reactions in digestion but do not neutralize stomach acid.

2. An essential nutrient must:

• A. be eaten every day
• B. be obtained by the diet
• C. be water soluble
• D. be eaten at every meal

Correct answer: B

Rationale: The correct answer is B: 'be obtained by the diet.' Essential nutrients are those that the body cannot synthesize in sufficient quantities and must therefore be obtained through the diet. Choice A is incorrect because not all essential nutrients need to be consumed daily; the frequency of consumption varies. Choice C is incorrect because not all essential nutrients are water-soluble; they can be water-soluble or fat-soluble. Choice D is incorrect because essential nutrients do not need to be consumed at every meal, but rather need to be included in the overall diet regularly.

3. The nurse is working with a patient who recently had a stroke. The patient frequently chokes and coughs when eating and is having difficulty feeding herself. What is the best way to ensure adequate nutrition?

• A. to have an aide feed her at each meal
• B. to ask a family member to assist during meals
• C. to provide tube feedings for the patient
• D. to initiate TPN for the patient

Correct answer: C

Rationale: The best way to ensure adequate nutrition for a stroke patient who frequently chokes and coughs when eating and has difficulty feeding herself is to provide tube feedings. Tube feedings are a safe and effective method to deliver nutrition directly to the stomach or intestines, bypassing the swallowing mechanism, reducing the risk of aspiration. Having an aide feed her each meal (choice A) may not address the underlying issue of swallowing difficulty and aspiration risk. Asking a family member to be present at each meal (choice B) does not provide a definitive solution to the patient's nutritional needs. Placing the patient on total parenteral nutrition (TPN) (choice D) is a more invasive and typically reserved for patients who cannot tolerate enteral feedings or have non-functional gastrointestinal tracts.

4. Surgery schedules are communicated to the OR usually a day prior to the procedure by the nurse of the floor or ward where the patient is confined. For orthopedic cases, what department is usually informed to be present in the OR?

• A. Rehabilitation department
• B. Laboratory department
• C. Maintenance department
• D. Radiology department

Correct answer: D

Rationale: Understanding the underlying pathology and therapeutic techniques ensures that nursing care is not only reactive but also preventative, reducing the risk of complications.

5. Which of the following gauges should you prepare for spinal anesthesia if the anesthesiologist requires a pink spinal set and a blue spinal set as backup?

• A. Gauges 16 and 22
• B. Gauges 18 and 16
• C. Gauges 16 and 20
• D. Gauges 25 and 22

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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