Nursing Elites

1. A 56-year-old white male complains of intermittent dysphagia for the past three months, particularly with the ingestion of meat. He has no difficulties swallowing liquids. He has no history of smoking, uses no medications, and has had no weight loss. What test would be best to evaluate him?

• A. Upper endoscopy
• B. Chest/abdominal CT scan
• C. Barium swallow
• D. Esophageal manometry

Correct answer: C

Rationale: For a patient presenting with intermittent dysphagia, especially with solids like meat, a barium swallow is the most appropriate initial test. In this case, the classic presentation suggests a Schatzki’s ring, which is best visualized through a barium study. Upper endoscopy may not always visualize Schatzki’s rings effectively. Chest/abdominal CT scan and esophageal manometry are not the preferred tests for diagnosing Schatzki’s rings. Treatment for Schatzki’s rings often involves bougie dilatation, and no further therapy may be necessary.

2. A patient with anemia is prescribed ferrous sulfate. What advice should the nurse give regarding the administration of this medication?

• A. Take with dairy products to increase absorption.
• B. Take on an empty stomach for best absorption.
• C. Avoid vitamin C while taking this medication.
• D. Take before bedtime.

Correct answer: B

Rationale: The correct advice for the administration of ferrous sulfate is to take it on an empty stomach for best absorption. This enhances the absorption of iron. If gastrointestinal upset occurs, the medication can be taken with food. Taking ferrous sulfate with dairy products is not recommended as calcium can inhibit iron absorption. Taking it before bedtime is also not recommended. Vitamin C can actually help with the absorption of iron and is often recommended to be taken alongside iron supplements to enhance absorption. Therefore, avoiding vitamin C while taking ferrous sulfate is not correct.

3. After undergoing rigid fixation for a mandibular fracture from a fight, what area of care should the nurse prioritize for discharge education for this client?

• A. Resumption of activities of daily living
• B. Pain control
• C. Promotion of adequate nutrition
• D. Strategies for promoting adequate nutrition

Correct answer: C

Rationale: The correct answer is promoting adequate nutrition. Following rigid fixation for a mandibular fracture, the client may have limitations in jaw movement, which can affect their ability to eat properly. Prioritizing education on promoting adequate nutrition will help ensure the client's nutritional needs are met during the recovery period.

4. After a client's neck dissection surgery resulted in damage to the superior laryngeal nerve, what area of assessment should the nurse prioritize?

• A. The client's swallowing ability
• B. The client's ability to speak
• C. The client's management of secretions
• D. The client's airway patency

Correct answer: A

Rationale: Damage to the superior laryngeal nerve can lead to swallowing difficulties due to impaired laryngeal function. As a result, assessing the client's swallowing ability is crucial to prevent aspiration and ensure proper nutrition and hydration.

5. When a client reports being allergic to penicillin, which question should the nurse ask to gather more information?

• A. Are you allergic to any other medications?
• B. How often have you taken penicillin in the past?
• C. Is anyone else in your family allergic to penicillin?
• D. What happens to you when you take penicillin?

Correct answer: D

Rationale: Questioning the client about the specific allergic reaction to penicillin is crucial for assessing the severity and type of allergic response, aiding in determining appropriate treatment and avoiding potential adverse reactions.

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