Nursing Elites

1. When assessing older adult clients for malnutrition at an adult day care center, which risk factors should the nurse consider?

• A. Dental problems
• B. Depression
• C. Both A and B
• D. Ability to prepare meals

Correct answer: C

Rationale: The correct answer is C: Both A and B. Dental problems and depression are both significant risk factors for malnutrition in older adults. Dental problems can lead to difficulty in chewing and swallowing, resulting in reduced food intake. On the other hand, depression can cause changes in appetite and decreased interest in eating, which can also contribute to malnutrition. Although the ability to prepare meals is important, it is not specifically identified as a risk factor for malnutrition within the context of this question. Therefore, choices A and B are the most appropriate answers.

2. You are on duty in the medical ward. You were asked to check the narcotics cabinet. You found out that what is on record does not tally with the drugs used. What will you do first?

• A. Write an incident report and refer the matter to the nursing director
• B. Keep your findings to yourself
• C. Report the matter to your supervisor
• D. Find out from the endorsement any patient who might have been given narcotics

Correct answer: C

Rationale: In this situation, the first step should be to report the matter to your supervisor. It is essential to notify the appropriate authority immediately to address the discrepancy in the narcotics cabinet. Choice A is not the first step as reporting to the nursing director should follow after informing the supervisor. Keeping the findings to yourself (Choice B) is not appropriate as it may jeopardize patient safety and is against ethical standards. While finding out which patient received narcotics (Choice D) is important, it is not the immediate action to take in this scenario.

3. A nurse is initiating continuous enteral feedings for a client who has a new gastrostomy tube. Which of the following actions should the nurse take?

• A. Measure the client’s gastric residual every 12 hours.
• B. Obtain the client’s electrolyte levels every 4 hours.
• C. Keep the client’s head elevated at 15° during feedings.
• D. Flush the client’s tube with 30 mL of water every 4 hours.

Correct answer: D

Rationale: Flushing the client’s tube with 30 mL of water every 4 hours is essential to maintain tube patency and prevent blockages. This action helps ensure the continuous flow of enteral feedings without obstruction. Measuring the client’s gastric residual every 12 hours (Choice A) is important but not the priority when initiating enteral feedings. Obtaining the client’s electrolyte levels every 4 hours (Choice B) is unnecessary and not directly related to tube feeding initiation. Keeping the client’s head elevated at 15° during feedings (Choice C) is a good practice to prevent aspiration, but tube flushing is more crucial to prevent tube occlusion.

4. Which medical condition is characterized by symptoms such as oral candidiasis, hairy leukoplakia, herpetic ulcerations, Kaposi's sarcoma, xerostomia, and severe periodontal disease?

• A. Acquired Immunodeficiency Syndrome (AIDS)
• B. Acute Leukemia
• C. Anorexia Nervosa
• D. Bulimia

Correct answer: A

Rationale: Acquired Immunodeficiency Syndrome (AIDS) is known for a variety of oral manifestations such as oral candidiasis, hairy leukoplakia, herpetic ulcerations, Kaposi's sarcoma, xerostomia, and severe periodontal disease. These symptoms are not typically associated with acute leukemia, anorexia nervosa, or bulimia. Acute leukemia usually presents with symptoms like fatigue, frequent infections, and easy bruising. Anorexia nervosa and bulimia are eating disorders, thus their primary symptoms are primarily associated with eating habits and body weight, not oral health.

5. In a patient with osteoporosis, which mineral is essential to prevent further bone loss?

• A. Iron
• B. Phosphorus
• C. Magnesium
• D. Calcium

Correct answer: D

Rationale: Calcium is crucial in preventing bone loss in patients with osteoporosis.

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