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. Which of the following are the primary bacteria involved in the initiation of dental caries?

• A. Streptococcus mutans and Lactobacillus species
• B. Salmonella and Listeria species
• C. Streptococcus, Lactobacillus, and Salmonella species
• D. Listeria, Botulinum species, and Escherichia coli

Correct answer: A

Rationale: The correct answer is A: Streptococcus mutans and Lactobacillus species. These bacteria are primarily responsible for initiating dental caries by fermenting carbohydrates and producing acids that demineralize enamel. Choice B, Salmonella and Listeria species, are not the primary bacteria involved in dental caries. Choice C includes Salmonella which is not a primary culprit in dental caries. Choice D lists Listeria, Botulinum species, and Escherichia coli, none of which are the primary bacteria associated with initiating dental caries.

3. Patients with kidney stones should increase their intake of:

• A. fluids
• B. vitamin C
• C. oxalates
• D. protein

Correct answer: A

Rationale: Patients with kidney stones should increase their intake of fluids. Increasing fluid intake helps to dilute the urine and reduce the risk of kidney stones forming by flushing out minerals that can crystallize. This promotes the passage of small stones and helps prevent the formation of new ones. Vitamin C and protein intake should be moderated as excessive consumption may lead to the formation of certain types of kidney stones. Oxalates should be limited in the diet as they can contribute to the formation of calcium oxalate stones, a common type of kidney stone.

4. You notice that Miss Kate, a bread vendor, receives and changes money, then holds the bread without washing her hands. As a nurse, what should you say to Miss Kate?

• A. Miss, don't touch the bread, I'll be the one to pick it up.
• B. Miss, please wash your hands before you pick up the bread.
• C. Miss, use a pick-up forceps when picking up the bread.
• D. Miss, your hands are dirty, I guess I'll try another bread shop.

Correct answer: B

Rationale: The correct answer is B, as it emphasizes the importance of hygiene in food handling, which is crucial to prevent the spread of germs and diseases. The other options do not address the root of the issue, which is the unhygienic handling of food. Option A avoids direct confrontation but does not educate the vendor on proper hygiene. Option C, although it suggests a hygienic method, may not be practical or available in all situations. Option D is an avoidance strategy rather than a way to address the problem.

5. 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).

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