Nursing Elites

1. A nurse is providing teaching to a group of parents of newborns who are planning to formula feed. Which of the following statements by a parent indicates a need for further teaching?

• A. "I will give formula to my baby at room temperature."
• B. "I will ensure my baby's feeds last 10 to 15 minutes."
• C. "I will burp my baby halfway through each feeding."
• D. "I will watch for signs my baby is full and stop the feeding."

Correct answer: B

Rationale: The correct answer is, "I will ensure my baby's feeds last 10 to 15 minutes." This statement indicates a need for further teaching because it suggests a strict time limit for feedings, which may not be appropriate for a newborn. Newborns should be allowed to feed as long as they want, typically around 20-30 minutes per breast if breastfeeding, or on-demand with formula. Choices A, C, and D demonstrate proper feeding practices such as feeding at room temperature, burping halfway through each feeding, and watching for signs of fullness to stop the feeding, which are all appropriate responses by a parent of a formula-fed newborn.

2. The counting of sponges is done by the Surgeon together with the:

• A. Circulating nurse
• B. Scrub nurse
• C. Assistant surgeon
• D. Nurse supervisor

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. Select all that apply. Characteristics of the 2 main types of essential fatty acids discussed in class include:

• A. they must be supplied by the diet
• B. they can be produced by a process called dehydrogenation
• C. they are anti-inflammatory
• D. they are all polyunsaturated fatty acids

Correct answer: A

Rationale: The correct answer is A: 'they must be supplied by the diet.' Essential fatty acids, like omega-3 and omega-6, cannot be produced by the body and must be obtained through the diet. They are polyunsaturated fatty acids, playing vital roles in inflammation and cell membrane structure. Choice B is incorrect because essential fatty acids cannot be produced by dehydrogenation, a process of removing hydrogen. Choice C is incorrect as not all essential fatty acids are anti-inflammatory; some have pro-inflammatory roles. Choice D is incorrect because not all essential fatty acids are polyunsaturated; omega-9, for example, is a monounsaturated essential fatty acid.

4. A client who has chronic lymphocytic leukemia is starting chemotherapy treatments and asks if she needs to make any dietary changes. Which of the following statements should the nurse make?

• A. "You should avoid drinking liquids an hour before the treatments."?
• B. "Eating low-calorie foods helps prevent nausea."?
• C. "Foods that are higher in fat are usually more appealing."?
• D. "Raw fruits and vegetables will be easier for your body to digest."?

Correct answer: D

Rationale: During chemotherapy treatments for chronic lymphocytic leukemia, raw fruits and vegetables are recommended as they are easier for the body to digest. This choice provides essential nutrients and is gentle on the digestive system. Option A is incorrect because staying hydrated is crucial during chemotherapy. Option B is incorrect as low-calorie foods may not provide sufficient energy during treatment. Option C is incorrect because high-fat foods are not typically recommended due to potential digestive issues.

5. 24 hours after the creation of a colostomy, what should Nurse Violy identify as the normal appearance of the stoma?

• A. Pink, moist, and slightly protruding from the abdomen
• B. Gray, moist, and slightly protruding from the abdomen
• C. Pink, dry, and slightly protruding from the abdomen
• D. Red, moist, and slightly protruding from the abdomen

Correct answer: A

Rationale: Following colostomy surgery, a healthy stoma should appear pink, moist, and slightly protruding from the abdomen, which is why option 'A' is the correct answer. A gray stoma (choice 'B') could indicate poor blood supply or necrosis, which is a serious complication. A dry stoma (choice 'C') is also not normal as it should be moist; a dry stoma may suggest dehydration or other complications. While a stoma can appear red (choice 'D'), this is not typically the normal color; it should usually be pink. Therefore, it's important for healthcare professionals to correctly identify the normal and abnormal appearances of a stoma to ensure proper patient care.

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