Nursing Elites

1. Which of the following foods should be avoided by clients who are prone to developing heartburn as a result of gastroesophageal reflux disease (GERD)?

• A. lettuce
• B. eggs
• C. chocolate
• D. butterscotch

Correct answer: C

Rationale: The correct answer is chocolate. Ingestion of chocolate can reduce lower esophageal sphincter (LES) pressure, leading to reflux and clinical symptoms of GERD. Lettuce and eggs do not significantly affect LES pressure, making them less likely to trigger GERD symptoms. Butterscotch, like lettuce and eggs, does not have a notable effect on LES pressure, so it is not as likely to worsen GERD symptoms as chocolate. Therefore, chocolate is the food to be avoided by clients prone to heartburn due to GERD.

2. What is a predisposing factor for cancer of the tongue?

• A. tobacco use
• B. obesity
• C. sun exposure
• D. eating sweets

Correct answer: A

Rationale: Tobacco use is a well-established predisposing factor for cancer of the tongue. Smoking or chewing tobacco can lead to the development of oral cancers, including those affecting the tongue. Obesity, sun exposure, and eating sweets are not directly linked to an increased risk of tongue cancer. Obesity may be associated with other types of cancer, sun exposure can lead to skin cancer, and eating sweets is not a known risk factor for tongue cancer. Therefore, the correct answer is tobacco use, as it has a strong association with the development of tongue cancer, making it a significant predisposing factor.

3. When ambulating a client with right-sided weakness, a nursing assistant should be positioned on which side of the client?

• A. Stands behind the client
• B. Positions the free hand on the client's shoulder
• C. Stands on the right side of the client
• D. Grasps the security belt in the midspine area of the small of the client's back

Correct answer: C

Rationale: When ambulating a client with right-sided weakness, the nursing assistant should stand on the affected side, which in this case is the client's right side. This position allows the assistant to provide proper support and assistance. Standing behind the client (Choice A) is incorrect as the assistant should be on the affected side. Positioning the free hand on the client's shoulder (Choice B) is a correct action as it helps in pulling the client toward them in case of a forward fall. Grasping the security belt in the midspine area of the small of the client's back (Choice D) is also correct to provide support and stability during ambulation.

4. When providing perineal care to a female client, how should the nurse perform the procedure?

• A. with gloves, washing the perineal area from front to back
• B. without gloves, having the client perform all care
• C. with gloves, washing the perineal area from back to front
• D. without gloves, pouring water from a sterile bottle

Correct answer: A

Rationale: When providing perineal care to a female client, the nurse should wear gloves and wash the perineal area from front to back. This technique helps prevent the introduction of E. coli and other bacteria into the urethra, reducing the risk of urinary tract infections. Washing from back to front can introduce bacteria from the anal area to the urethra, leading to infections. Performing the procedure without gloves or having the client perform all care does not adhere to infection control practices. Pouring water from a sterile bottle alone may not ensure proper cleansing and infection prevention. Therefore, choices B, C, and D are incorrect as they do not follow proper perineal care guidelines.

5. A 20-year-old male client had a diving accident with subsequent paraplegia. He says to the nurse, "No woman will ever want to marry me now."? Which of the following responses by the nurse is most therapeutic?

• A. "Don't worry. Maybe you'll meet a paraplegic woman."?
• B. "There is someone for everyone in this world."?
• C. "You are still an attractive man, even though you can't walk."?
• D. "Tell me more about your feelings on this issue."?

Correct answer: D

Rationale: The correct response is 'Tell me more about your feelings on this issue.' This answer is the most therapeutic as it encourages the client to express his emotions and concerns, fostering a supportive and open dialogue between the client and the nurse. Option A may come across as dismissive and does not directly address the client's emotional state. Option B, while positive, oversimplifies the client's complex feelings. Option C focuses only on physical appearance, missing the opportunity to delve deeper into the client's emotional well-being. Therefore, the most therapeutic response is to encourage further discussion about the client's feelings.

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