Nursing Elites

1. A client has bilateral eye patches in place following an injury. When the client's food tray arrives, which of the following interventions should the nurse take to promote independence in eating?

• A. Assign an assistive personnel to feed the client.
• B. Explain to the client that their tray is here and guide their hands to it.
• C. Describe to the client the location of the food on the tray.
• D. Ask the client if they would prefer a liquid diet.

Correct answer: C

Rationale: When a client has bilateral eye patches, promoting independence in eating is crucial to maintain dignity and autonomy. Describing the location of the food on the tray enables the client to locate and feed themselves. Assigning assistive personnel to feed the client (Choice A) takes away their independence. Merely informing the client that the tray is here and guiding their hands to it (Choice B) does not empower the client to eat independently. Asking if the client prefers a liquid diet (Choice D) is not directly addressing the client's ability to independently eat the current meal.

2. Increasing the variety of foods often prevents nutrient excesses and toxicities. A dietary change to eliminate or increase intake of one specific food or nutrient usually alters the intake of other nutrients.

• A. Both statements are true.
• B. Both statements are false.
• C. The first statement is true; the second is false.
• D. The first statement is false; the second is true.

Correct answer: D

Rationale: The first statement is false because increasing the variety of foods actually helps prevent nutrient excesses and toxicities. The second statement is true because making a dietary change to eliminate or increase the intake of a specific food or nutrient often leads to alterations in the intake of other nutrients. Choice A is incorrect because the first statement is false. Choice B is incorrect because the second statement is true. Choice C is incorrect because the first statement is false, even though the second statement is true.

3. Skin care around the stoma is critical. Which of the following is not indicated as a skin care barriers?

• A. Apply liberal amount of mineral oil to the area
• B. Use karaya paste and rings around the stoma
• C. Clean the area daily with soap and water before applying bag
• D. Apply talcum powder twice a day

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.

4. What are the potential consequences of damage to the stomach?

• A. Reduced digestion of carbohydrates
• B. Inability to produce or secrete bile
• C. Inability to produce or secrete gastric acid
• D. Increased ability to produce or secrete intrinsic factor

Correct answer: C

Rationale: Damage to the stomach can lead to a reduced ability to produce gastric acid (Choice C) and intrinsic factor, the latter of which is crucial for vitamin B12 absorption (Choice D). That's why these two choices are correct. The stomach doesn't play a direct role in the digestion of carbohydrates (Choice A) as this process primarily occurs in the small intestine with the help of pancreatic enzymes. Similarly, bile is produced by the liver and stored in the gallbladder, not the stomach, hence stomach damage wouldn't lead to an inability to produce or secrete bile (Choice B).

5. The nurse is assessing a client with a new diagnosis of Listeria food poisoning. What action should the nurse take first?

• A. Educate the client on safe food practices.
• B. Start a traceback to identify the source of the outbreak.
• C. Report the case to the county board of health.
• D. Ask the client if they have consumed any unpasteurized products.

Correct answer: D

Rationale: The correct first action for the nurse to take when assessing a client with a new diagnosis of Listeria food poisoning is to inquire if the client has consumed any unpasteurized products. This is crucial because Listeria contamination is often associated with unpasteurized dairy products and undercooked meats. Educating the client on safe food practices (Choice A) is important but not the priority at this initial assessment stage. Starting a traceback to identify the source of the outbreak (Choice B) and reporting the case to the county board of health (Choice C) are necessary actions but should come after gathering information directly from the client regarding potential exposure to high-risk foods.

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