Nursing Elites

1. Each statement is true regarding oral exposure to fermentable carbohydrates, except one. Which is the exception?

• A. Longer exposure leads to an increased risk of demineralization
• B. Longer exposure increases the opportunity for remineralization
• C. The Stephan curve illustrates pH changes within plaque after rinsing with a sugar solution
• D. The critical pH at which enamel decalcification occurs is 5.5 or less

Correct answer: B

Rationale: All the statements above are accurate about oral exposure to fermentable carbohydrates, except for option B. In fact, longer exposure to these carbohydrates decreases the opportunity for remineralization. This is because the process of demineralization, in which minerals are lost from the tooth enamel, is sped up by the presence of fermentable carbohydrates. The Stephan curve (option C) is a graph that demonstrates how the pH of dental plaque changes after a sugar rinse, usually dropping (becoming more acidic), which can lead to enamel decalcification. Option D is also accurate, as a pH of 5.5 or lower is the critical point at which enamel starts to decalcify.

2. A nurse is assessing a client who reports muscle spasms in his calves and tingling in his hands. The client indicates consuming a low intake of milk products and green leafy vegetables. The nurse should identify that the client's findings indicate a deficiency in which of the following sources of nutrition?

• A. Iron
• B. Omega-3 fatty acids
• C. Vitamin C
• D. Calcium

Correct answer: D

Rationale: The correct answer is D, Calcium. Muscle spasms and tingling suggest a calcium deficiency, which is commonly associated with a low intake of milk products and green leafy vegetables. Iron (choice A) deficiency typically presents with fatigue and weakness, not muscle spasms and tingling. Omega-3 fatty acids (choice B) are essential for brain function and heart health, but their deficiency does not manifest as muscle spasms and tingling. Vitamin C (choice C) deficiency leads to scurvy with symptoms like bleeding gums and bruising, not muscle spasms and tingling.

3. 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.

4. Lynn is an older adult who lives alone and has requested advice on how to eat a nutritious diet as cheaply as possible. One useful, practical tip for Lynn might be to _____.

• A. buy just a few pieces of fresh fruit at a time, in different stages of ripeness
• B. choose small boxes of frozen vegetables instead of large bags
• C. purchase pre-sliced or shredded cheese rather than whole pieces
• D. avoid buying certain foods in bulk, such as beans or dried legumes

Correct answer: A

Rationale: Buying a few pieces of fresh fruit at different stages of ripeness ensures that Lynn will have ripe fruit available over several days, reducing waste and cost. Choice B focuses on frozen vegetables but doesn't address the variety and ripeness factor like Choice A. Choice C is about cheese, which may not be as essential for a nutritious diet compared to fresh fruit. Choice D suggests avoiding certain foods in bulk, which might not be as relevant for maintaining a nutritious diet economically as the strategy in Choice A.

5. Baby John develops hyperbilirubinemia. What is a method used to treat hyperbilirubinemia in a newborn?

• A. Keeping infants in a warm and dark environment
• B. Administration of cardiovascular stimulant
• C. Gentle exercise to stop muscle breakdown
• D. Early feeding to speed passage of meconium

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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