Nursing Elites

1. Each statement is true of swallowing and processing food, except one. Which is the exception?

• A. The swallowing reflex moves a bolus into the esophagus
• B. A bolus is a mass of food
• C. The bolus is transported to the stomach by osmosis and gravity
• D. The bolus penetrates the diaphragm through the esophageal hiatus

Correct answer: C

Rationale: The correct answer is C. The bolus is not transported to the stomach by osmosis and gravity, but by peristalsis. Peristalsis is the involuntary constriction and relaxation of muscles to push the bolus through the digestive system. Choices A, B, and D are correct statements. A bolus is indeed a mass of food, the swallowing reflex does move the bolus into the esophagus, and the bolus does not penetrate the diaphragm through the esophageal hiatus; instead, it enters the stomach through the lower esophageal sphincter.

2. Sergio is brought to Emergency Room after the barbecue grill accident. Based on the assessment of the physician, Sergio sustained superficial partial thickness burns on his trunk, right upper extremities and right lower extremities. His wife asks what that means? Your most accurate response would be:

• A. Structures beneath the skin are damage
• B. Dermis is partially damaged
• C. Epidermis and dermis are both damaged
• D. Epidermis is damaged

Correct answer: B

Rationale: Nursing interventions should be grounded in a deep understanding of the physiological processes involved, ensuring that care provided is both effective and efficient.

3. A nurse is planning care for a toddler who has burns over 50% total body surface area. Which of the following actions should the nurse include in the plan of care?

• A. Administer enteral feedings
• B. Limit intake of vitamin C
• C. Limit dietary protein
• D. Administer insulin prior to meals

Correct answer: A

Rationale: Administering enteral feedings is crucial for ensuring adequate nutrition and supporting healing in toddlers with extensive burns. Burns over 50% total body surface area can lead to increased metabolic demands, making it essential to provide nutrition through enteral feedings to meet the child's needs for healing and recovery. Limiting intake of vitamin C or dietary protein would be detrimental in this scenario as the child requires increased amounts of nutrients to support healing. Administering insulin prior to meals is not indicated in this case as the priority is to provide adequate nutrition to promote healing.

4. A client with Crohn's disease is receiving parenteral nutrition. Which of the following interventions should the nurse not include in the care of this client?

• A. Remove the parenteral nutrition solution from the refrigerator 2 hours before infusion.
• B. Remove unused parenteral nutrition after 12 hours of use.
• C. Monitor daily laboratory values and report abnormalities as needed.
• D. Monitor the flow rate of the parenteral nutrition carefully and adjust it if necessary.

Correct answer: B

Rationale: In caring for a client receiving parenteral nutrition, it is important to follow proper guidelines to ensure safety and effectiveness. Unused parenteral nutrition should be removed after 24 hours, not 12 hours, to prevent contamination and reduce the risk of infection. Option A is correct as it ensures the solution is at room temperature before infusion. Option C is essential for monitoring the client's response to parenteral nutrition. Option D is important to maintain the correct flow rate and adjust it as needed. Therefore, option B is the incorrect choice among the options provided.

5. The recommended daily fluid intake of patients maintained using hemodialysis is:

• A. 150 mL plus the volume of urinary output
• B. 500 mL plus the volume of urinary output
• C. 1000 mL plus the volume of urinary output
• D. 1500 mL plus the volume of urinary output

Correct answer: C

Rationale: The correct answer is C: 1000 mL plus the volume of urinary output. Fluid intake is typically restricted in hemodialysis patients to prevent fluid overload. The recommended daily fluid intake for these patients is 1000 mL plus any urinary output. Choice A (150 mL plus the volume of urinary output) is too low and would not provide enough fluid for these patients. Choice B (500 mL plus the volume of urinary output) is also insufficient. Choice D (1500 mL plus the volume of urinary output) is too high and may lead to fluid overload in hemodialysis patients.

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