Nursing Elites

1. For an incontinent elderly client who frequently wets his bed and develops redness and skin excoriation at the perianal area, what is the best nursing goal?

• A. Ensure that the bed linen is always dry
• B. Frequently check the bed for wetness and keep it dry
• C. Place a rubber sheet under the client's buttocks
• D. Keep the patient clean and dry

Correct answer: A

Rationale: The best nursing goal for an incontinent elderly client with skin excoriation is to ensure that the bed linen is always dry. This helps in preventing further skin breakdown and promoting skin integrity. Choice B, to frequently check the bed for wetness and keep it dry, may not address the issue of prevention if the linen is not consistently dry. Choice C, placing a rubber sheet under the client's buttocks, focuses more on protecting the mattress rather than addressing the client's skin condition directly. Choice D, keeping the patient clean and dry, is important but does not specifically address the preventive aspect of maintaining dry bed linen.

2. Where does carbohydrate digestion begin?

• A. Mouth
• B. Esophagus
• C. Stomach
• D. Small intestine

Correct answer: A

Rationale: Carbohydrate digestion begins in the mouth. The enzyme amylase, found in saliva, starts the process by breaking down starches into sugars. The esophagus is a passageway for food to reach the stomach and does not participate in digestion. The stomach mainly digests proteins and is not the primary site for carbohydrate breakdown. While the small intestine does play a crucial role in digesting carbohydrates, it is not where the process initiates. Therefore, the correct answer is the mouth.

3. A client has a small-bore jejunostomy and is receiving a continuous tube feeding with a high-viscosity formula. Which of the following actions should the nurse take to prevent the tubing from clogging?

• A. Replace the bag and tubing every 24 hours
• B. Flush the tubing with 10 mL water every 6 hours
• C. Administer the feeding by gravity drip
• D. Heat the formula prior to infusion

Correct answer: B

Rationale: To prevent clogging when using high-viscosity formulas in a small-bore jejunostomy, the nurse should flush the tubing with 10 mL of water every 6 hours. This action helps maintain tube patency and prevent blockages. Replacing the bag and tubing every 24 hours (Choice A) is unnecessary and does not specifically address preventing clogging. Administering the feeding by gravity drip (Choice C) or heating the formula prior to infusion (Choice D) are not effective interventions for preventing tubing clogging.

4. The healthcare professional in the dialysis unit understands that patients may experience various complications during hemodialysis. What describes a common complication during hemodialysis?

• A. confusion
• B. profuse sweating
• C. hypertension
• D. leg cramps

Correct answer: D

Rationale: Leg cramps are a common complication during hemodialysis due to shifts in fluid and electrolyte levels that occur during the treatment. Confusion (choice A) is not a common complication specifically related to hemodialysis. Profuse sweating (choice B) is not typically associated with hemodialysis complications. Hypertension (choice C) might be a pre-existing condition in some patients but is not a direct common complication of hemodialysis.

5. Each statement is true of fat-soluble vitamins, except one. Which is the exception?

• A. Fairly stable to heat, such as during cooking
• B. Contain carbon
• C. Stored in the pancreas
• D. Absorbed in the intestine along with fats and lipids in food

Correct answer: C

Rationale: Fat-soluble vitamins are not stored in the pancreas; they are stored in the liver and fatty tissues. Choice A is correct as fat-soluble vitamins are fairly stable to heat. Choice B is also correct as fat-soluble vitamins contain carbon. Choice D is correct as fat-soluble vitamins are absorbed in the intestine along with fats and lipids in food.

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