Nursing Elites

1. All of the following are instructions for proper foot care to be given to a client with peripheral vascular disease caused by diabetes. Which one is not?

• A. Trim nails using a nail clipper
• B. Apply cornstarch to the foot
• C. Always check the temperature of the water before bathing
• D. Use canvas shoes

Correct answer: A

Rationale: The correct answer is 'A', which says trim nails using a nail clipper. This is incorrect because patients with peripheral vascular disease, particularly those caused by diabetes, should not trim their nails themselves due to the risk of injury, infection, and poor wound healing. The other options, 'B', 'C', and 'D', are correct advice for diabetic foot care. Applying cornstarch can help keep the feet dry and prevent fungal infections. Checking the water temperature before bathing can prevent burns, as patients with peripheral vascular disease often have decreased sensation in their feet. Wearing canvas shoes can improve foot ventilation and reduce the risk of foot ulcers and infections.

2. A client who underwent surgical placement of a colostomy is being cared for by a nurse. Which of the following statements indicates the client understands the dietary teaching?

• A. "Eating yogurt can help decrease the amount of gas that I have."?
• B. "I should eliminate pasta from my diet so that I don't have as many loose stools."?
• C. "My largest meal of the day should be in the evening."?
• D. "Carbonated beverages can help control odor."?

Correct answer: D

Rationale: The correct answer is D. Carbonated beverages can help control odor in clients with colostomies. This is because carbonated drinks can help decrease odor by reducing the production of odoriferous compounds in the colon. Choices A, B, and C are incorrect. Eating yogurt may help regulate bowel movements but does not specifically address odor control associated with colostomies. Eliminating pasta from the diet to reduce loose stools is not necessary for colostomy care. The timing of the largest meal of the day is not directly related to dietary teaching for colostomy care.

3. You are on duty in the medical ward. The mother of your patient who is also a nurse, came running to the nurses station and informed you that Fiolo went into cardiopulmonary arrest.

• A. Start basic life support measures
• B. Call for the Code
• C. Bring the crash cart to the room
• D. Go to see Fiolo and assess for airway patency and breathing problems

Correct answer: C

Rationale: Effective nursing care involves comprehensive assessments that address all aspects of a patient's condition, ensuring that interventions are appropriately targeted and outcomes are optimized.

4. Sugar alcohols have anticariogenic properties and can protect the teeth by decreasing demineralization, enhancing remineralization, or increasing salivary flow, even in the presence of a fermentable carbohydrate. Name 3 sugar alcohols.

• A. Sorbitol
• B. Mannitol
• C. Xylitol
• D. Erythritol

Correct answer: D

Rationale: Sugar alcohols such as sorbitol, mannitol, and xylitol are commonly used in sugar-free products and have properties that help protect teeth from caries by promoting remineralization and increasing salivary flow. Erythritol is another common sugar alcohol used as a sweetener in various products, but it was not listed in the question.

5. You are taking care of critically ill client and the doctor in charge calls to order a DNR (do not resuscitate) for the client. Which of the following is the appropriate action when getting DNR order over the phone?

• A. Have the registered nurse, family spokesperson, nurse supervisor and doctor sign
• B. Have 2 nurse validate the phone order, both nurses sign the order and the doctor should sign his order within 24
• C. Have the registered nurse, family and doctor sign the order
• D. Have 1 nurse take the order and sign it and have the doctor sign it within 24 hours

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.

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