Nursing Elites

1. A client who is 2 days postoperative following abdominal surgery is about to progress from a clear liquid diet to full liquids. Which of the following items should the nurse tell the client he may now request to have on his meal tray?

• A. Cranberry juice
• B. Flavored gelatin
• C. Skim milk
• D. Chicken broth

Correct answer: A

Rationale: Cranberry juice is an appropriate choice for a client transitioning from a clear liquid diet to full liquids post abdominal surgery. It provides hydration and some essential nutrients. Flavored gelatin is usually allowed on a clear liquid diet and may not be suitable for a full liquids phase. Skim milk and chicken broth are typically introduced in a later stage of the diet progression, closer to a soft diet, due to their higher protein and fat content.

2. You are to apply a transdermal patch of nitoglycerin to your client. The following are important guidelines to observe EXCEPT:

• A. Apply to hairless clean area of the skin not subject to much wrinkling
• B. Patches may be applied to distal part of the extremities like forearm
• C. Change application and site regularly to prevent irritation of the skin
• D. Wear gloves to avoid any medication on your hand

Correct answer: D

Rationale: Understanding the underlying pathology and therapeutic techniques ensures that nursing care is not only reactive but also preventative, reducing the risk of complications.

3. Which condition is most closely associated with a high rate of gastroesophageal reflux disease?

• A. Pregnancy
• B. Anorexia
• C. Hypertension
• D. Diabetes mellitus

Correct answer: A

Rationale: Pregnancy is the correct answer as it is most closely associated with a high rate of gastroesophageal reflux disease (GERD). During pregnancy, the growing fetus exerts pressure on the stomach, leading to the backflow of stomach acid into the esophagus, causing GERD. This physiological change is a common occurrence in pregnant individuals. Conversely, anorexia, hypertension, and diabetes mellitus are not typically linked to a high rate of GERD. While these conditions have their own effects on the body, they do not directly contribute to the mechanisms that cause GERD, unlike the physical changes associated with pregnancy. Therefore, choices B, C, and D are incorrect.

4. Mario listens to Richard’s bilateral sounds and finds that congestion is in the upper lobes of the lungs. The appropriate position to drain the anterior and posterior apical segments of the lungs when Mario does percussion would be:

• A. Client lying on his back then flat on his abdomen on Trendelenburg position
• B. Client seated upright in bed or on a chair then leaning forward in sitting position then flat on his back and on his
• C. Client lying flat on his back and then flat on his abdomen
• D. Client lying on his right then left side on Trendelenburg position

Correct answer: A

Rationale: Proper patient positioning is essential for maximizing lung expansion and promoting the drainage of secretions. Postural drainage techniques rely on gravity to help clear different lung segments, which is critical in preventing complications such as atelectasis or pneumonia in immobilized patients.

5. Cariogenic foods and beverages, which are fermentable carbohydrates that can be metabolized by oral bacteria, reduce salivary pH to what critical level?

• A. 5
• B. 5.5
• C. 6
• D. 6.5

Correct answer: B

Rationale: Cariogenic foods and beverages lower the pH level in the mouth to below 5.5. This is a critical threshold, as it is the point at which enamel begins to demineralize, increasing the risk of dental caries. Therefore, options 'A', 'C', and 'D' are incorrect. Although a pH level of 5, as suggested by option 'A', would indeed lead to demineralization, it's not the threshold value. The pH levels suggested by options 'C' and 'D' (6 and 6.5, respectively) are higher than the critical value of 5.5, which means they would not initiate enamel demineralization and the subsequent risk of dental caries.

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