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 chemical structure is represented by glycerol combined with two fatty acids?

• A. Compound lipids
• B. Monoglycerides
• C. Diglycerides
• D. Structural lipids

Correct answer: C

Rationale: The correct answer is C: Diglycerides. A diglyceride is a glycerol molecule combined with two fatty acids. This is a common form of fat during digestion and absorption. Choice A, Compound lipids, is incorrect because these lipids are composed of simple lipids plus additional compounds, which is not the case with a glycerol molecule combined with two fatty acids. Choice B, Monoglycerides, is incorrect because these are glycerol molecules combined with only one fatty acid, not two. Lastly, choice D, Structural lipids, is incorrect because these are major components of cell membranes and do not directly relate to the combination of glycerol and two fatty acids.

3. When counseling a teenager about fast food, a dental hygienist could correctly cite which of the following facts, with one exception. Which is the exception?

• A. Most fast food menus lack a rich source of vitamin A
• B. Consumer demands have driven the establishment of salads and other healthy menu items
• C. Shortages of biotin, folate, pantothenic acid, and copper are reported in fast foods
• D. Studies reveal that protein is lacking in most menu items

Correct answer: D

Rationale: The correct answer is 'D'. Fast food is generally not deficient in protein since it often contains meat, a significant source of protein. On the other hand, fast food is known to lack essential nutrients like Vitamin A and certain minerals, as mentioned in choices 'A' and 'C'. Choice 'B' is also accurate as many fast food establishments have started offering healthier options such as salads due to customer demands. Therefore, all options are true except 'D', which makes it the exception.

4. Each statement is true regarding oral exposure to fermentable carbohydrates, except one. Which is the exception?

• A. Longer exposure leads to an increased risk of demineralization
• B. Longer exposure increases the opportunity for remineralization
• C. The Stephan curve illustrates pH changes within plaque after rinsing with a sugar solution
• D. The critical pH at which enamel decalcification occurs is 5.5 or less

Correct answer: B

Rationale: All the statements above are accurate about oral exposure to fermentable carbohydrates, except for option B. In fact, longer exposure to these carbohydrates decreases the opportunity for remineralization. This is because the process of demineralization, in which minerals are lost from the tooth enamel, is sped up by the presence of fermentable carbohydrates. The Stephan curve (option C) is a graph that demonstrates how the pH of dental plaque changes after a sugar rinse, usually dropping (becoming more acidic), which can lead to enamel decalcification. Option D is also accurate, as a pH of 5.5 or lower is the critical point at which enamel starts to decalcify.

5. Which food item interferes with the effectiveness of warfarin?

• A. Cauliflower
• B. Zucchini
• C. Green beans
• D. Broccoli

Correct answer: D

Rationale: Broccoli is high in vitamin K, which can affect the effectiveness of warfarin. Warfarin is an anticoagulant medication that functions by reducing the activity of vitamin K in the body. When one consumes broccoli, which is rich in vitamin K, it could counteract the anticoagulant effect of warfarin, thereby interfering with its effectiveness. On the other hand, cauliflower, zucchini, and green beans do not have significant levels of vitamin K and hence, are not known to impact the effectiveness of warfarin.

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