Nursing Elites

1. A dental hygienist finds several new carious lesions in a patient with chronic obstructive respiratory disease (COPD). While conducting the medical and dental histories, the dental hygienist is most likely to find an increased use of which of the following?

• A. Protein
• B. Cough drops
• C. Fluoride
• D. Xylitol

Correct answer: B

Rationale: The correct answer is B: Cough drops. Patients with COPD often use cough drops to manage their symptoms, which can lead to an increase in carious lesions due to their sugar content. Choices A, C, and D are incorrect as protein, fluoride, and xylitol are not typically associated with an increased risk of carious lesions in patients with COPD.

2. The PACU nurse will maintain postoperative T and A client in what position?

• A. Supine with neck hyperextended and supported with pillow
• B. Prone with the head on pillow and turned to the side
• C. Semi-fowler’s with neck flexed
• D. Reverse trendelenburg with extended neck

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.

3. What instruction should the nurse include on weight gain during pregnancy?

• A. Failure to obtain the required weight gain during pregnancy will increase the risk of preterm birth.
• B. An obese client needs to gain as much weight as a client with a normal body mass index.
• C. A client with a normal body mass index should plan on gaining 50 pounds.
• D. Clients will need to eat for two when they are pregnant.

Correct answer: A

Rationale: Appropriate weight gain is crucial for reducing the risk of preterm birth.

4. A nurse is caring for a client who has cancer and is receiving total parenteral nutrition (TPN). Which of the following lab values indicates the treatment is effective?

• A. Hct 43%
• B. WBC 8,000/uL
• C. Albumin 4.2 g/dL
• D. Calcium 9.4 mg/dL

Correct answer: C

Rationale: The correct answer is Albumin 4.2 g/dL. Albumin is a protein produced by the liver and is a key indicator of nutritional status. In a client receiving total parenteral nutrition (TPN), an increase in albumin level indicates that the treatment is effective in providing adequate nutrition support. Hct (hematocrit), WBC (white blood cell count), and calcium levels are not direct indicators of the effectiveness of TPN in this context.

5. Which of the following interventions should be considered the highest priority when caring for June, who has hemiparesis secondary to a stroke?

• A. Position June in an upright lateral position
• B. Perform range of motion exercises
• C. Apply antiembolic stockings
• D. Use hand rolls or pillows for support

Correct answer: C

Rationale: The correct answer is C, 'Apply antiembolic stockings'. In the case of a patient who has experienced a stroke and is suffering from hemiparesis, the highest priority intervention is to prevent further complications such as deep vein thrombosis (DVT), which can be life-threatening. Antiembolic stockings are used to increase venous blood flow velocity and reduce the risk of DVT. Choice 'A', positioning June in an upright lateral position, while important for overall care, is not the highest priority. Choice 'B', performing range of motion exercises, is an important part of recovery but not the immediate priority. Choice 'D', using hand rolls or pillows for support, is also a valuable intervention but does not address the most pressing risk of further complications.

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