Nursing Elites

1. Children with cerebral palsy, Down syndrome, and intellectual disabilities are likely to have abnormal sensory input and muscle tone. A small, underdeveloped tongue is common in many such disorders and results in diminished nutritional status.

• A. Both statements are true
• B. Both statements are false
• C. The first statement is true; the second is false
• D. The first statement is false; the second is true

Correct answer: C

Rationale: The first statement is true, but the second is false. These children often have a large tongue or tongue thrust, which can interfere with feeding and nutrition.

2. Which systemic disease is best controlled with the DASH diet, monitoring blood pressure, limiting sodium, alcohol, and caffeine, reducing stress, and losing weight?

• A. Hypertension
• B. Diabetes mellitus
• C. Parkinson's disease
• D. Anemia

Correct answer: A

Rationale: The correct answer is A: Hypertension. The DASH diet is specifically designed to control hypertension by reducing sodium intake, managing blood pressure, and promoting overall cardiovascular health. Choice B, Diabetes mellitus, is managed through monitoring blood sugar levels and a balanced diet rich in whole grains, fruits, and vegetables. Choice C, Parkinson's disease, is a neurological disorder that is not primarily managed through diet modifications. Choice D, Anemia, is a condition characterized by a lack of healthy red blood cells and is typically managed by addressing the underlying cause and sometimes iron supplementation, not by the methods mentioned in the question.

3. A nurse is caring for four clients. The nurse should plan to administer total parenteral nutrition for which of the following clients?

• A. A client who is postoperative following a laminectomy and is receiving IV PCA
• B. A client who has dysphagia and does not recognize his family
• C. A client who has COPD and is going home with oxygen
• D. A client who has colon cancer and will undergo a hemicolectomy

Correct answer: D

Rationale: Total parenteral nutrition (TPN) is essential for clients undergoing significant surgical procedures like a hemicolectomy to ensure they receive adequate nutrition when oral intake is not possible. Choices A, B, and C do not typically require TPN. Choice A is managing postoperative pain with IV PCA, choice B is likely to need alternative feeding methods due to dysphagia, and choice C is going home with oxygen for COPD management, which does not directly relate to the need for TPN.

4. When taking a blood pressure reading, where should the cuff be positioned?

• A. The cuff should be deflated fully before immediately starting a second reading for the same patient
• B. The cuff should be deflated quickly after being inflated to 180 mmHg
• C. The cuff should be large enough to wrap around the upper arm of the adult patient, positioned 1 cm above the brachial artery
• D. The cuff should be inflated to 30 mmHg above the estimated systolic BP based on palpation of the radial or brachial artery

Correct answer: D

Rationale: When measuring blood pressure, the cuff should be inflated to 30 mmHg above the estimated systolic blood pressure based on palpation of the radial or brachial artery. This ensures an accurate blood pressure measurement. Choices A, B, and C are incorrect. Deflating the cuff fully before starting a second reading (Choice A) does not directly relate to the position of the cuff during a reading. Deflating the cuff quickly after inflating to 180 mmHg (Choice B) is not recommended because it can potentially lead to inaccurate readings. While ensuring the cuff is large enough to wrap around the upper arm positioned 1 cm above the brachial artery is important (Choice C), this alone does not guarantee an accurate blood pressure reading. The correct inflation based on palpation is the key element for accuracy, which is why Choice D is correct.

5. Scurvy is caused by a deficiency of ascorbic acid (Vitamin C) because ascorbic acid is required for collagen synthesis. Is this statement true or false?

• A. TRUE
• B. FALSE
• C. Not applicable
• D. Not applicable

Correct answer: A

Rationale: The statement is accurate. Scurvy is indeed caused by a deficiency in ascorbic acid, which is another name for Vitamin C. This vitamin plays a crucial role in the synthesis of collagen, a protein that helps in the formation and strength of skin, blood vessels, tissues, and bones. When the body lacks Vitamin C, it cannot produce enough collagen, leading to symptoms associated with scurvy such as bleeding gums and weakened immunity. The choice 'False' is incorrect because it contradicts the proven medical and scientific understanding of the causes of scurvy. Choices 'C' and 'D' are marked as 'Not applicable' because the question only requires a true or false answer.

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