Nursing Elites

1. A client has acute dysphagia. Which of the following nursing interventions should be included in the plan of care?

• A. Providing a straw for consumption of liquids
• B. Encouraging larger bites
• C. Placing the client in semi-Fowler's position during meals
• D. Instructing the client to tilt head forward when swallowing

Correct answer: C

Rationale: Placing the client in semi-Fowler's position during meals is the correct intervention for a client with acute dysphagia. This position helps prevent aspiration by facilitating swallowing. Providing a straw for consumption of liquids (Choice A) can increase the risk of aspiration and is not recommended for clients with dysphagia. Encouraging larger bites (Choice B) can also increase the risk of choking and aspiration. Instructing the client to tilt the head forward when swallowing (Choice D) is not the recommended technique for managing dysphagia as it does not address the underlying issue effectively.

2. For an incontinent elderly client who frequently wets his bed and develops redness and skin excoriation at the perianal area, what is the best nursing goal?

• A. Ensure that the bed linen is always dry
• B. Frequently check the bed for wetness and keep it dry
• C. Place a rubber sheet under the client's buttocks
• D. Keep the patient clean and dry

Correct answer: A

Rationale: The best nursing goal for an incontinent elderly client with skin excoriation is to ensure that the bed linen is always dry. This helps in preventing further skin breakdown and promoting skin integrity. Choice B, to frequently check the bed for wetness and keep it dry, may not address the issue of prevention if the linen is not consistently dry. Choice C, placing a rubber sheet under the client's buttocks, focuses more on protecting the mattress rather than addressing the client's skin condition directly. Choice D, keeping the patient clean and dry, is important but does not specifically address the preventive aspect of maintaining dry bed linen.

3. In a therapeutic relationship, the nurse must understand own values, beliefs, feelings, prejudices & how these affect others. This is called:

• A. Therapeutic use of self
• B. Psychotherapy
• C. Therapeutic communication
• D. Self awareness

Correct answer: A

Rationale: Patient safety and efficacy of care depend on actions rooted in established nursing protocols that consider both the immediate and long-term needs of the patient.

4. Which physiologic role does vitamin C play in the body?

• A. Transcribing DNA to RNA
• B. Absorption and regulation of calcium
• C. Protects integrity of cellular membranes
• D. Catalyst for synthesis of blood-clotting factors

Correct answer: C

Rationale: Vitamin C plays a crucial role in protecting the integrity of cellular membranes. It is essential for collagen synthesis, which is important for wound healing and maintaining skin, blood vessels, and other tissues. Choice A is incorrect as the transcription of DNA to RNA is facilitated by vitamin A. Choice B is incorrect as calcium absorption and regulation are functions of vitamin D. Choice D is incorrect as vitamin K serves as a catalyst for the synthesis of blood-clotting factors, not vitamin C.

5. Can bacterial plaque metabolize sucrose, lactose, and fructose? Is fructose, also known as levulose and found naturally in honey, less cariogenic than sucrose and lactose?

• A. Yes, bacterial plaque can metabolize these sugars, but no, fructose is not less cariogenic.
• B. No, bacterial plaque cannot metabolize these sugars, and fructose is not less cariogenic.
• C. Yes, bacterial plaque can metabolize these sugars, but no, fructose is not less cariogenic.
• D. No, bacterial plaque cannot metabolize these sugars, but yes, fructose is less cariogenic.

Correct answer: A

Rationale: The first statement is correct as bacterial plaque can indeed metabolize sucrose, lactose, and fructose. However, the second statement is inaccurate. Fructose, despite being found naturally in honey and known also as levulose, is not less cariogenic than either sucrose or lactose. This means that its consumption does not result in fewer cavities or tooth decay. Therefore, the correct answer is that bacterial plaque can metabolize these sugars, but fructose is not less cariogenic. Choices B, C, and D are incorrect because they either wrongly assert that bacterial plaque cannot metabolize these sugars or wrongly claim that fructose is less cariogenic.

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